{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:27:08Z","timestamp":1786976828750,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,1,14]],"date-time":"2022-01-14T00:00:00Z","timestamp":1642118400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Several studies have described techniques aimed at mitigating olfactory dysfunction after nasoseptal flap (NSF) harvest for endoscopic skull base surgery (ESBS). No consensus exists as to whether popular methods including using cold steel (CS) versus electrocautery (EC) or septal olfactory strip (SOS) preservation offer an advantage. This systematic review was performed to examine the impact of these two technical variations of NSF harvest on postoperative olfactory outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA guidelines, PubMed, Scopus, and Web of Science were searched for articles reporting olfactory outcomes in ESBS cases employing an NSF. Original articles focusing on technique variations of the NSF and reporting at least one objective olfactory measure were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine studies comprising 610 patients were included. Various, olfactory testing outcomes were reported, and postoperative follow\u2010up ranged from 6\u00a0weeks to 12 months. Three studies, including a randomized controlled trial, compared the use of CS and EC for the superior incision of the NSF. No significant difference was found in objective olfactory function (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&gt;\u00a00.05) when comparing these techniques. Five studies comprising 504 patients reported results from SOS\u2010sparing. SOS\u2010sparing technique in NSF harvest demonstrated smell preservation in the postoperative setting when compared with preoperative measures (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&gt;\u00a00.05); however, no direct comparison to non\u2010SOS\u2010sparing techniques was made.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The use of CS as opposed to EC for the superior NSF incision does not appear to confer an advantage in preserving postoperative olfactory function (grade B evidence). SOS preservation may be associated with better olfactory outcomes in NSF harvest (grade C evidence).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.22945","type":"journal-article","created":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T10:24:55Z","timestamp":1639563895000},"page":"1043-1055","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Systematic review of olfactory outcomes after nasoseptal flap harvest for endoscopic skull base surgery: Does using cold steel or olfactory strip preservation matter?"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7903-2299","authenticated-orcid":false,"given":"Suat","family":"K\u0131l\u0131\u00e7","sequence":"first","affiliation":[{"name":"Section of Sinus, Rhinology, &amp; Skull Base Surgery, Head and Neck Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0384-9870","authenticated-orcid":false,"given":"Satyan B.","family":"Sreenath","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Indiana University  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Grafmiller","sequence":"additional","affiliation":[{"name":"Section of Sinus, Rhinology, &amp; Skull Base Surgery, Head and Neck Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4723-6681","authenticated-orcid":false,"given":"Troy D.","family":"Woodard","sequence":"additional","affiliation":[{"name":"Section of Sinus, Rhinology, &amp; Skull Base Surgery, Head and Neck Institute Cleveland Clinic  Cleveland Ohio USA"},{"name":"Section of Skull Base Surgery, Rose Ella Burkhardt Brain Tumor and Neuro\u2010oncology Center Neurological Institute, Cleveland Clinic  Cleveland Ohio USA"},{"name":"Department of Neurological Surgery Cleveland Clinic Lerner College of Medicine of Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9748-2784","authenticated-orcid":false,"given":"Pablo F.","family":"Recinos","sequence":"additional","affiliation":[{"name":"Section of Sinus, Rhinology, &amp; Skull Base Surgery, Head and Neck Institute Cleveland Clinic  Cleveland Ohio USA"},{"name":"Section of Skull Base Surgery, Rose Ella Burkhardt Brain Tumor and Neuro\u2010oncology Center Neurological Institute, Cleveland Clinic  Cleveland Ohio USA"},{"name":"Department of Neurological Surgery Cleveland Clinic Lerner College of Medicine of Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun R.","family":"Kshettry","sequence":"additional","affiliation":[{"name":"Section of Sinus, Rhinology, &amp; 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