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Additionally, a systematic review and meta-analysis with focus on the rhinologic outcome, including postoperative smell function was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The institutional series incorporated 168 patients. A concomitant endoscopic septoplasty was performed in 29\/168 patients (17.3%). A nasoseptal flap was used for reconstruction of large skull-base defects or high-flow CSF leaks in 4\/168 (2.4%) patients. Early postoperative rhinologic complications (&lt;\u20094\u00a0weeks) included epistaxis (3%), acute rhinosinusitis (1.2%) and late postoperative complications (\u2265\u20098\u00a0weeks) comprised prolonged crusting (15.6%), symptomatic synechiae (11.9%) and septal perforation (0.6%). Postoperative smell function was not impaired (Fisher\u2019s exact test,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.0). The systematic review included 19 studies on 1533 patients with a median postoperative epistaxis rate of 1.4% (IQR 1.0\u20132.2), a postoperative acute rhinosinusitis rate of 2.3% (IQR 2.1\u20133.0), a postoperative synechiae rate of 7.5% (IQR 1.8\u201319.1) and a postoperative septal perforation rate of 2.2% (IQR 0.5\u20135.4). Seven studies including a total of 206 patients reported adequate outcome measures for smell function before and after ETT surgery. Only 2\/7 studies reported an impairment of smell function postoperatively, especially in patients with nasoseptal flap harvesting.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early and late postoperative rhinologic complication rates after ETT surgery for pituitary lesions seem to be low. A thorough evaluation of smell function, in particular in patients at risk for nasoseptal flap harvesting, may be an important factor in optimal postoperative care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00405-023-07934-w","type":"journal-article","created":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T10:03:09Z","timestamp":1680084189000},"page":"4091-4099","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Rhinologic outcome of endoscopic transnasal-transsphenoidal pituitary surgery: an institutional series, systematic review, and meta-analysis"],"prefix":"10.1007","volume":"280","author":[{"given":"Nathalie A.","family":"Gstrein","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Zwicky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Serra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hugelshofer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Regli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael B.","family":"Soyka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Holzmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8674-1007","authenticated-orcid":false,"given":"Christian M.","family":"Meerwein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,3,29]]},"reference":[{"key":"7934_CR1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199202000-00016","author":"R Jankowski","year":"1992","unstructured":"Jankowski R, Auque J, Simon C et al (1992) Endoscopic pituitary tumor surgery. 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