Purpose of review: As endoscopic skull base surgery advances and becomes more common, recognizing and understanding all possible risks and complications of these procedures is a significant responsibility of the operating surgeon. Olfaction is a deficit often ignored or trivialized by the treating physician, in spite of its loss causing major impacts on our patients' quality of life.
Recent findings: Olfactory dysfunction after endoscopic skull base surgery is still being debated in the literature, with evidence supporting both sides. With some studies denying any loss, others suggesting temporary deficits, and still others showing long-term damage, standardization of testing and high levels of awareness of this possible complication should be the prevailing practice.
Summary: Future goals of any endoscopic skull base surgeon should be to use objective olfactory testing before and after surgery, collect information on rates of dysfunction in their patients, and offer treatment options as necessary while tracking the efficacy of those options in this patient population.