Improvements in site-specific quality of life 6 months after endoscopic anterior skull base surgery: a prospective study

2012 ◽  
Vol 117 (3) ◽  
pp. 498-506 ◽  
Author(s):  
Edward D. McCoul ◽  
Vijay K. Anand ◽  
Theodore H. Schwartz
Keyword(s):  
Quality Of Life ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Anterior Skull Base ◽  
Gross Total Resection ◽  
Total Resection ◽  
Site Specific ◽  
Endoscopic Skull Base Surgery ◽  
Snot 22

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.

scholarly journals Adherus Dural Sealant in Endoscopic Skull Base Surgery: Safety, Imaging Characteristics, and Sinonasal Quality of Life

2019 ◽  
Vol 81 (06) ◽  
pp. 659-663
Author(s):  
Christian P. Soneru ◽  
Charles A. Riley ◽  
Shlomo Minkowitz ◽  
Abtin Tabaee ◽  
Vijay K. Anand ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Consecutive Series ◽  
Complication Rates ◽  
Tumor Type ◽  
Endoscopic Skull Base Surgery ◽  
Imaging Characteristics ◽  
Snot 22

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.

Prospective validation of a patient-reported nasal quality-of-life tool for endonasal skull base surgery: The Anterior Skull Base Nasal Inventory-12

2013 ◽  
Vol 119 (4) ◽  
pp. 1068-1074 ◽  
Author(s):  
Andrew S. Little ◽  
Daniel Kelly ◽  
John Milligan ◽  
Chester Griffiths ◽  
Gail Rosseau ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Anterior Skull Base ◽  
Psychometric Validation ◽  
Severe Problem ◽  
Site Specific ◽  
Patient Reported ◽  
Final Instrument

Object Patient-reported quality-of-life (QOL) end points are becoming increasingly important health care metrics. To date, no nasal morbidity instrument specifically designed for patients undergoing endonasal skull base surgery has been developed. In this study, the authors describe the development and validation of a site-specific nasal morbidity instrument to assess patient-reported rhinological outcomes following endonasal skull base surgery. Methods Eligible patients included those with planned endonasal transsphenoidal surgery for sellar pathology identified in outpatient neurosurgical clinics of 3 skull base centers from October 2011 to July 2012. An initial 23-question pool was developed by subject matter experts, review of the literature, and from the results of a previous validation study to assess for common rhinological complaints. Symptoms were ranked by patients from “No Problem” to “Severe Problem” on a 6-point Likert scale. Exploratory factor analysis, change scores, and importance rank were calculated to define the final instrument consisting of 12 items (The Anterior Skull Base Nasal Inventory-12, or ASK Nasal-12). Psychometric validation of the final instrument was performed using standard statistical techniques. Results One hundred four patients enrolled in the study. All patients completed the preoperative survey and 100 patients (96%) completed the survey 2–4 weeks after surgery. Internal consistency of the final instrument was 0.88. Concurrent validity measures demonstrated a strong correlation between overall nasal functioning and total scores (p < 0.001). Test-retest reliability measures demonstrated a significant intraclass correlation between responses (p < 0.001). Effect size as calculated by standardized response mean suggested a large effect (0.84). Discriminant validity calculations demonstrated that the instrument was able to discriminate between preoperative and postoperative patients (p < 0.001). Conclusions This prospective study demonstrates that the ASK Nasal-12 is a validated, site-specific, unidimensional rhinological outcomes tool sensitive to clinical change. It can be used in conjunction with multidimensional QOL instruments to assess patient-reported nasal perceptions in endonasal skull base surgery. This instrument is being used as a primary outcome measure in an ongoing multicenter nasal morbidity study. Clinical trial registration no.: NCT01504399 (ClinicalTrials.gov).

Site-Specific Quality of Life after Endoscopic Anterior Skull Base Surgery

Skull Base ◽  
2011 ◽  
Vol 21 (S 01) ◽  
Author(s):  
Edward McCoul ◽  
Vijay Anand ◽  
Theodore Schwartz
Keyword(s):  
Quality Of Life ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Anterior Skull Base ◽  
Site Specific

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 ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Endoscopic Skull Base Surgery

scholarly journals Quality-of-Life after Anterior Skull Base Surgery: A Systematic Review

2013 ◽  
Vol 75 (02) ◽  
pp. 073-089 ◽  
Author(s):  
Anouk Borg ◽  
Alaa Al-Mousa ◽  
Nikolaos Haliasos ◽  
David Choi ◽  
Matthew Kirkman
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Anterior Skull Base

Quality of life and emotional burden after transnasal and transcranial anterior skull base surgery

2019 ◽  
Vol 161 (12) ◽  
pp. 2527-2537 ◽  
Author(s):  
Arthur Wagner ◽  
Youssef Shiban ◽  
Verena Kammermeier ◽  
Ann-Kathrin Joerger ◽  
Nicole Lange ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Anterior Skull Base ◽  
Emotional Burden

Quality of Life Evaluation After Trans-Nasal Endoscopic Surgery for Skull Base Tumors

2020 ◽  
pp. 194589242097204
Author(s):  
Gabriele Molteni ◽  
Andrea Sacchetto ◽  
Tommaso Saccardo ◽  
Antonio Gulino ◽  
Daniele Marchioni
Keyword(s):  
Quality Of Life ◽  
Skull Base ◽  
Endoscopic Surgery ◽  
Negative Impact ◽  
Anterior Skull Base ◽  
University Hospital ◽  
Average Score ◽  
Transnasal Approach ◽  
Snot 22

Background The excellent surgical results obtained with transnasal endoscopic approach to the anterior skull base (ASB) are universally recognized; less is known about the quality of life of patients after surgery. Objective The aim of this study is to analyze the quality of life of patients after endoscopic transnasal surgery for the treatment of neoplasms of the ASB. Methods We conducted a retrospective review of patients who underwent transnasal endoscopic surgery for treatment of ASB tumors at the Tertiary Referral Center University Hospital of Verona. All patients were asked to complete the Anterior Skull Base Questionnaire (ASBQ), the Skull Base Inventory (SBI), and the Sino-nasal Outcome Test – 22 Items (SNOT-22) after surgical treatment. The study population was divided into subgroups; a statistical analysis of the overall results and of the different questionnaire domains was performed. Results 51 patients were enrolled in this study. The average score was 3.04 for ASBQ, 4.05 for SBI and 28.88 for SNOT-22. Analysis of the overall results for the ASBQ showed a lower quality of life in patients after recurrent surgery and in female patients. The SBI showed similar results in relation to recurrent surgery and radiotherapy. Similarly, the results for SNOT-22 highlighted the negative impact of recurrent surgery and radiotherapy. Conclusion Our results confirmed that the endoscopic transnasal approach shows excellent results not only in terms of surgical outcome, but also for the possibility of ensuring a good QoL after treatment. Recurrent surgery and radiation treatments were the most important negative prognostic factors.

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