BACKGROUND: Endoscopic skull base surgery (ESBS) is considered a minimally-invasive surgical modality with less morbidity and patient discomfort. Quality-of-life (QOL) assessments provide a patient-reported estimate of well-being that may be clinically relevant. Although the sinonasal tract is integral to ESBS, the change in sinonasal-related QOL with ESBS has not been well studied. The aim of this study was to prospectively assess QOL before and after ESBS using validated outcome measures. METHODS: Consecutive adult patients undergoing ESBS for anterior skull base lesions were prospectively enrolled from a tertiary referral center. Each patient was asked to complete the 22-item Sinonasal Outcome Test (SNOT-22) and the Anterior Skull Base Questionnaire (ASBQ) preoperatively, and again at 3 weeks, 6 weeks, 12 weeks, 6 months, and 1 year postoperatively. RESULTS: Eighty-five patients were included for study, 44.7% of whom underwent ESBS for nonpituitary pathology. Mean SNOT-22 scores transiently worsened in the early postoperative period, and significantly improved at 1 year after surgery (p < 0.01). Gross-total tumor resection and use of autologous grafting materials were associated with improved SNOT-22 scores at later time points (p < 0.05). Type of reconstruction, tumor pathology, and functionality did not affect QOL scores. Correlation between SNOT-22 and ASBQ scores was good at all time points (r < -0.50). Cerebrospinal fluid leak and other complications were uncommon. CONCLUSION: ESBS does not have a detrimental long-term effect and is associated with ultimate improvement in sinonasal-related QOL. Short-term impairments of sinonasal-related QOL are predictable and self-limited. Prospective assessment using sinonasal-related and site-specific QOL instruments provide complementary information about ESBS outcomes.
BACKGROUND: Endoscopic skull base surgery (ESBS) is considered a minimally-invasive surgical modality with less morbidity and patient discomfort. Quality-of-life (QOL) assessments provide a patient-reported estimate of well-being that may be clinically relevant. Although the sinonasal tract is integral to ESBS, the change in sinonasal-related QOL with ESBS has not been well studied. The aim of this study was to prospectively assess QOL before and after ESBS using validated outcome measures. METHODS: Consecutive adult patients undergoing ESBS for anterior skull base lesions were prospectively enrolled from a tertiary referral center. Each patient was asked to complete the 22-item Sinonasal Outcome Test (SNOT-22) and the Anterior Skull Base Questionnaire (ASBQ) preoperatively, and again at 3 weeks, 6 weeks, 12 weeks, 6 months, and 1 year postoperatively. RESULTS: Eighty-five patients were included for study, 44.7% of whom underwent ESBS for nonpituitary pathology. Mean SNOT-22 scores transiently worsened in the early postoperative period, and significantly improved at 1 year after surgery (p < 0.01). Gross-total tumor resection and use of autologous grafting materials were associated with improved SNOT-22 scores at later time points (p < 0.05). Type of reconstruction, tumor pathology, and functionality did not affect QOL scores. Correlation between SNOT-22 and ASBQ scores was good at all time points (r < -0.50). Cerebrospinal fluid leak and other complications were uncommon. CONCLUSION:ESBS does not have a detrimental long-term effect and is associated with ultimate improvement in sinonasal-related QOL. Short-term impairments of sinonasal-related QOL are predictable and self-limited. Prospective assessment using sinonasal-related and site-specific QOL instruments provide complementary information about ESBS outcomes.
Authors: Ellen Ten Dam; Astrid G W Korsten-Meijer; Rutger H Schepers; Wicher J van der Meer; Peter O Gerrits; Bernard F A M van der Laan; Robert A Feijen Journal: Eur Arch Otorhinolaryngol Date: 2014-10-31 Impact factor: 2.503
Authors: Ricardo Landini Lutaif Dolci; Lígia Tédde de Moraes; Ana Carolina Mayor de Carvalho; Jeniffer Cristina Kozechen Rickli; Jamile Lopes de Souza; Williams Escalante Encinas; José Viana Lima Junior; Nilza Maria Scalissi; Américo Rubens Leite Dos Santos; Paulo Roberto Lazarini Journal: Eur Arch Otorhinolaryngol Date: 2020-09-28 Impact factor: 2.503