Olfactory outcomes following endoscopic pituitary surgery with or without septal flap reconstruction: a randomized controlled trial
Why this work is in the frame
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Bibliographic record
Abstract
BACKGROUND: Postoperative hyposmia and anosmia is an often overlooked complication of endoscopic pituitary surgery. Septal flaps have been utilized as a strategy for repairing and preventing postoperative cerebrospinal fluid (CSF) leaks. The olfactory impact of raising this flap for sellar reconstruction and CSF repair needs qualitative assessment. This study aims to ascertain the effect of the Hadad-Bassagasteguy (HB) flap on olfaction in endoscopic pituitary surgery. METHODS: In this randomized controlled trial, patients undergoing pituitary surgery underwent computerized randomization. Those in Group 1 all had HB flaps raised and placed for sellar floor defects. Those in Group 2 underwent reconstruction with synthetic or nonautologous materials. The University of Pennsylvania Smell Identification Test (UPSIT) was administered preoperatively and 6 months postoperatively. Results were analyzed using nonparametric tests. RESULTS: Twenty subjects were enrolled, 10 in each group. Eight subjects in Group 1 vs 3 in Group 2 had intraoperative CSF leak. All were repaired intraoperatively and none required additional intervention. Preoperatively, UPSIT scores were not significantly different between groups (p = 0.62). Preoperative vs postoperative comparisons were significant for a decrease in scores in both groups postoperatively (Group 1, p < 0.001; Group 2, p < 0.001). Those undergoing HB flap reconstruction had significantly worse scores postoperatively (p = 0.001). CONCLUSION: Endoscopic pituitary surgery results in decreased olfaction with or without deploying a septal flap. However, use of the HB flap for reconstruction can worsen hyposmia at least 6 months after surgery. Olfaction should be considered when use of the HB flap is planned.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it