Feasibility and Efficacy of Olfactory Protection Using Gelfoam and Fibrin Glue during Anterior Communicating Artery Aneurysm Surgery.
10.3340/jkns.2015.58.2.107
- Author:
Hoyeon CHO
1
;
Kyung Il JO
;
Je Young YEON
;
Seung Chyul HONG
;
Jong Soo KIM
Author Information
1. Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jsns.kim@samsung.com
- Publication Type:Original Article
- Keywords:
Olfactory dysfunction;
Pterional approach;
A-com aneurysm;
Aneurysm clipping;
Olfactory protection
- MeSH:
Aneurysm;
Arteries;
Fibrin Tissue Adhesive*;
Fibrin*;
Gelatin Sponge, Absorbable*;
Humans;
Intracranial Aneurysm*;
Medical Records;
Olfaction Disorders;
Quality of Life;
Retrospective Studies;
Surgical Instruments
- From:Journal of Korean Neurosurgical Society
2015;58(2):107-111
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Patients treated with surgical clipping for anterior communicating artery (A-com) aneurysm often complain of anosmia, which can markedly impede their quality of life. We introduce a simple and useful technique to reduce postoperative olfactory dysfunction in A-com aneurysm surgery. METHODS: We retrospectively reviewed the medical records of patients who underwent surgical clipping for unruptured aneurysm from 2011-2013 by the same senior attending physician. Since March 2012, olfactory protection using gelfoam and fibrin glue was applied in A-com aneurysm surgery. Therefore we categorized patients in two groups from this time-protected group and unprotected group. RESULTS: Of the 63 enrolled patients, 16 patients showed postoperative olfactory dysfunction-including 8 anosmia patients (protected group : unprotected group=1 : 7) and 8 hyposmia patients (protected group : unprotected group=2 : 6). Thirty five patients who received olfactory protection during surgery showed a lower rate of anosmia (p=0.037, OR 10.516, 95% CI 1.159-95.449) and olfactory dysfunction (p=0.003, OR 8.693, 95% CI 2.138-35.356). Superior direction of the aneurysm was also associated with a risk of olfactory dysfunction (p=0.015, OR 5.535, 95% CI 1.390-22.039). CONCLUSION: Superior direction of aneurysm appears associated with postoperative olfactory dysfunction. Olfactory protection using gelfoam and fibrin glue could be a simple, safe, and useful method to preserve olfactory function during A-com aneurysm surgery.
