Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Feasibility and Efficacy of Olfactory Protection Using Gelfoam and Fibrin Glue during Anterior Communicating Artery Aneurysm Surgery

  • Cho, Hoyeon (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jo, Kyung-Il (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Yeon, Je Young (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Hong, Seung-Chyul (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Jong-Soo (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2015.02.16
  • Accepted : 2015.05.29
  • Published : 2015.08.28
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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.

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References

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