title: Smell preservation following endoscopic unilateral resection of esthesioneuroblastoma: a multi-institutional experience.
abstract: The gold standard of treatment for esthesioneuroblastoma consists of en bloc craniofacial resection with postoperative therapy dictated by histology and tumor extent. Numerous studies have shown fully endoscopic approaches to provide comparable survival and recurrence rates with decreased patient morbidity. Here we report the first multi-institutional series assessing smell outcomes of patients who underwent unilateral endoscopic resection of esthesioneuroblastoma with preservation of the contralateral olfactory bulb.
  
  
  
  A multi-institutional retrospective review was performed identifying patients who underwent endoscopic unilateral resection of esthesioneuroblastoma with preservation of 1 olfactory bulb between 2003 and 2015. After completion of postoperative radiation, patients were administered the University of Pennsylvania Smell Identification Test (UPSIT) to assess olfactory function.
  
  
  
  Fourteen patients (7 males, 7 females) were identified and tested for posttreatment olfactory function. All 14 patients received postoperative radiotherapy and 4 patients received additional chemotherapy. Mean follow-up time was 51.7 months. There was no disease recurrence. Six patients (43%) were found to have residual smell function with 2 patients (14%) having normal or mildly reduced smell function.
  
  
  
  Here we report the first multi-institutional series demonstrating smell preservation after unilateral endoscopic resection of esthesioneuroblastoma. In carefully selected patients, this approach can yield comparable survival with decreased patient morbidity.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, The University of Pennsylvania, Philadelphia, PA.
authors.forename: Bobby A
authors.initials: BA
authors.lastname: Tajudeen
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, The University of Pennsylvania, Philadelphia, PA.
authors.forename: Nithin D
authors.initials: ND
authors.lastname: Adappa
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, CA.
authors.forename: Edward C
authors.initials: EC
authors.lastname: Kuan
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, The University of Pennsylvania, Philadelphia, PA.
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Schwartz
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, CA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Suh
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, CA.
authors.forename: Marilene B
authors.initials: MB
authors.lastname: Wang
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, The University of Pennsylvania, Philadelphia, PA. james.palmer@uphs.upenn.edu.
authors.forename: James N
authors.initials: JN
authors.lastname: Palmer
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D004724:Endoscopy; D018304:Esthesioneuroblastoma, Olfactory / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000000981:diagnostic imaging / Q000601:surgery*; D009669:Nose Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D012903:Smell; D014057:Tomography, X-Ray Computed
keywords: anterior cranial; esthesioneuroblastoma; malignant; olfactory neuroblastoma; sinonasal tumor; skull base surgery; smell preservation