Quality of life after extended versus transsellar endoscopic skull base surgery from 767 patients

2018 ◽  
Vol 129 (6) ◽  
pp. 1318-1324 ◽  
Author(s):  
Min Young Seo ◽  
Do‐Hyun Nam ◽  
Doo‐Sik Kong ◽  
Jung Joo Lee ◽  
Gwanghui Ryu ◽  
...  
2019 ◽  
Vol 81 (06) ◽  
pp. 659-663
Author(s):  
Christian P. Soneru ◽  
Charles A. Riley ◽  
Shlomo Minkowitz ◽  
Abtin Tabaee ◽  
Vijay K. Anand ◽  
...  

Abstract Objective This study was aimed to compare the safety profiles, magnetic resonance imaging (MRI) findings, and sinonasal outcome test (SNOT-22) scores of Adherus dural sealant, a novel tissue glue designed for skull base surgery. Design Present study is a prospective case series. Setting The research work took place at a tertiary-care academic medical center. Participants Consecutive series of 26 patients undergoing endoscopic skull base surgery (ESBS) with Adherus was compared with a control group of 24 patients matched for tumor type and size with DuraSeal as a sealant. Main Outcome Measures Postoperative complication rates, imaging characteristics, and postoperative SNOT-22 scores were measured and compared. Results No postoperative cerebrospinal fluid (CSF) leaks, intracranial hemorrhages, or mucoceles were observed in either cohort. Adherus was more likely to be identifiable on immediate postoperative MRI (50 vs. 20.8%, p = 0.032). In patients in whom a nasoseptal flap was utilized, the flap was opposed to the skull base in all cases regardless of sealant selected. Postoperative SNOT-22 total (17.25 [±10.81] vs. 14.85 [±14.22], p = 0.609) and subdomain scores were similar between the two groups. Conclusions Adherus dural sealant appears to be a safe alternative to Duraseal in ESBS with comparable quality of life outcomes and imaging findings. These preliminary results are promising but should be examined in a larger population with long-term follow-up.


2014 ◽  
Vol 151 (1_suppl) ◽  
pp. P16-P16
Author(s):  
Ivan H. El-Sayed ◽  
Ehab Y. N. Hanna ◽  
Carl H. Snyderman ◽  
Michael E. Kupferman ◽  
Marc Rosen ◽  
...  

2012 ◽  
Vol 117 (3) ◽  
pp. 498-506 ◽  
Author(s):  
Edward D. McCoul ◽  
Vijay K. Anand ◽  
Theodore H. Schwartz

Object Endoscopic skull base surgery (ESBS) is a minimal-access technique that provides an alternative to traditional approaches. Patient-reported outcomes are becoming increasingly important in measuring the success of surgical interventions. Endoscopic skull base surgery may lead to improvements in quality of life (QOL) since natural orifices are used to reach the pathology; however, sinonasal QOL may be negatively affected. The purpose of this study was to assess the impact of ESBS on both site-specific QOL, using the Anterior Skull Base Questionnaire (ASBQ), and sinonasal-related QOL, using the Sino-Nasal Outcome Test (SNOT-22). Methods Consecutive patients from a tertiary referral center who were undergoing ESBS were prospectively enrolled in this study. All patients completed the ASBQ and SNOT-22 preoperatively as well as at regular intervals after ESBS. Results Sixty-six patients were included in the study, and 57.6% of them had pituitary adenoma. There was no significant decline or improvement in the ASBQ-measured QOL at 3 and 6 weeks after ESBS, but there were significant improvements at 12 weeks and 6 months postoperatively (p < 0.05). Improvements were noted in all but one ASBQ subdomain at 12 weeks and 6 months postsurgery (p < 0.05). Preoperative QOL was significantly worse in patients who had undergone revision surgery and significantly improved postoperatively in patients who underwent gross-total resection (p < 0.05). Scores on the SNOT-22 worsened at 3 weeks postoperatively and returned to baseline thereafter. The presence of a nasoseptal flap or a graft-donor site did not contribute to a decreased QOL. Conclusions Endoscopic skull base surgery is associated with an improvement in postoperative site-specific QOL as compared with the preoperative QOL. Short-term improvements are greater if gross-total resection is achieved. Sinonasal QOL transiently declines and then returns to preoperative baseline levels. Endoscopic skull base surgery is a valuable tool in the neurosurgical management of anterior skull base pathology, leading to improvements in site-specific QOL.


2012 ◽  
Vol 2 (2) ◽  
pp. 174-181 ◽  
Author(s):  
Edward D. McCoul ◽  
Vijay K. Anand ◽  
Jeffrey C. Bedrosian ◽  
Theodore H. Schwartz

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