Preserving olfactory function in anterior craniofacial surgery through cribriform plate osteotomy applied in selected patients

Iman Feiz-Erfan, Patrick P. Han, Robert F. Spetzler, Eric Horn, Jeffrey D. Klopfenstein, Louis J. Kim, Randall W. Porter, Stephen P. Beals, Salvatore C. Lettieri, Edward F. Joganic

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

OBJECTIVE: Olfaction is often sacrificed to gain access to the cranial base in anterior craniofacial surgery. We describe the long-term results of olfactory function in patients who underwent anterior craniofacial surgery and a cribriform plate osteotomy to preserve olfaction. METHODS: Between 1992 and 2004, 28 patients underwent 29 cribriform plate osteotomies in an attempt to preserve olfaction during anterior craniofacial surgery performed through modified extended transbasal approaches. Patients' charts and office notes were reviewed retrospectively. Formal olfactory testing was available in 5 patients, but most data were based on patients' subjective reports of olfaction. Olfactory preservation was defined by the subjective ability to detect fumes such as coffee, chocolate, roses, and orange juice regardless of the intensity of the sensation. Follow-up was based on phone calls to patients. RESULTS: Four patients were lost to follow-up and excluded. Therefore, follow-up was available in 24 patients after 25 procedures. On the basis of patients' subjective reports, olfaction was spared in 22 patients after 23 procedures (92%) and was confirmed objectively in the five patients formally tested. After surgery, only two patients were anosmic. CONCLUSION: Olfaction can be preserved in selected patients undergoing anterior craniofacial surgery. At least 1 cm of nasal mucosa should remain attached to the cribriform plate, which can be achieved by including the nasal bone in the osteotomy of the orbital bar. A medial orbital canthopexy is therefore necessary after these procedures.

Original languageEnglish (US)
JournalNeurosurgery
Volume57
Issue number1 SUPPL.
DOIs
StatePublished - Jul 2005
Externally publishedYes

Fingerprint

Ethmoid Bone
Osteotomy
Smell
Nasal Bone
Aptitude
Nasal Mucosa
Lost to Follow-Up
Coffee
Skull Base

Keywords

  • Approach
  • Craniofacial
  • Extradural
  • Olfaction

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Preserving olfactory function in anterior craniofacial surgery through cribriform plate osteotomy applied in selected patients. / Feiz-Erfan, Iman; Han, Patrick P.; Spetzler, Robert F.; Horn, Eric; Klopfenstein, Jeffrey D.; Kim, Louis J.; Porter, Randall W.; Beals, Stephen P.; Lettieri, Salvatore C.; Joganic, Edward F.

In: Neurosurgery, Vol. 57, No. 1 SUPPL., 07.2005.

Research output: Contribution to journalArticle

Feiz-Erfan, I, Han, PP, Spetzler, RF, Horn, E, Klopfenstein, JD, Kim, LJ, Porter, RW, Beals, SP, Lettieri, SC & Joganic, EF 2005, 'Preserving olfactory function in anterior craniofacial surgery through cribriform plate osteotomy applied in selected patients', Neurosurgery, vol. 57, no. 1 SUPPL.. https://doi.org/10.1227/01.NEU.0000163487.94463.4A
Feiz-Erfan, Iman ; Han, Patrick P. ; Spetzler, Robert F. ; Horn, Eric ; Klopfenstein, Jeffrey D. ; Kim, Louis J. ; Porter, Randall W. ; Beals, Stephen P. ; Lettieri, Salvatore C. ; Joganic, Edward F. / Preserving olfactory function in anterior craniofacial surgery through cribriform plate osteotomy applied in selected patients. In: Neurosurgery. 2005 ; Vol. 57, No. 1 SUPPL.
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AU - Han, Patrick P.

AU - Spetzler, Robert F.

AU - Horn, Eric

AU - Klopfenstein, Jeffrey D.

AU - Kim, Louis J.

AU - Porter, Randall W.

AU - Beals, Stephen P.

AU - Lettieri, Salvatore C.

AU - Joganic, Edward F.

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N2 - OBJECTIVE: Olfaction is often sacrificed to gain access to the cranial base in anterior craniofacial surgery. We describe the long-term results of olfactory function in patients who underwent anterior craniofacial surgery and a cribriform plate osteotomy to preserve olfaction. METHODS: Between 1992 and 2004, 28 patients underwent 29 cribriform plate osteotomies in an attempt to preserve olfaction during anterior craniofacial surgery performed through modified extended transbasal approaches. Patients' charts and office notes were reviewed retrospectively. Formal olfactory testing was available in 5 patients, but most data were based on patients' subjective reports of olfaction. Olfactory preservation was defined by the subjective ability to detect fumes such as coffee, chocolate, roses, and orange juice regardless of the intensity of the sensation. Follow-up was based on phone calls to patients. RESULTS: Four patients were lost to follow-up and excluded. Therefore, follow-up was available in 24 patients after 25 procedures. On the basis of patients' subjective reports, olfaction was spared in 22 patients after 23 procedures (92%) and was confirmed objectively in the five patients formally tested. After surgery, only two patients were anosmic. CONCLUSION: Olfaction can be preserved in selected patients undergoing anterior craniofacial surgery. At least 1 cm of nasal mucosa should remain attached to the cribriform plate, which can be achieved by including the nasal bone in the osteotomy of the orbital bar. A medial orbital canthopexy is therefore necessary after these procedures.

AB - OBJECTIVE: Olfaction is often sacrificed to gain access to the cranial base in anterior craniofacial surgery. We describe the long-term results of olfactory function in patients who underwent anterior craniofacial surgery and a cribriform plate osteotomy to preserve olfaction. METHODS: Between 1992 and 2004, 28 patients underwent 29 cribriform plate osteotomies in an attempt to preserve olfaction during anterior craniofacial surgery performed through modified extended transbasal approaches. Patients' charts and office notes were reviewed retrospectively. Formal olfactory testing was available in 5 patients, but most data were based on patients' subjective reports of olfaction. Olfactory preservation was defined by the subjective ability to detect fumes such as coffee, chocolate, roses, and orange juice regardless of the intensity of the sensation. Follow-up was based on phone calls to patients. RESULTS: Four patients were lost to follow-up and excluded. Therefore, follow-up was available in 24 patients after 25 procedures. On the basis of patients' subjective reports, olfaction was spared in 22 patients after 23 procedures (92%) and was confirmed objectively in the five patients formally tested. After surgery, only two patients were anosmic. CONCLUSION: Olfaction can be preserved in selected patients undergoing anterior craniofacial surgery. At least 1 cm of nasal mucosa should remain attached to the cribriform plate, which can be achieved by including the nasal bone in the osteotomy of the orbital bar. A medial orbital canthopexy is therefore necessary after these procedures.

KW - Approach

KW - Craniofacial

KW - Extradural

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