Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Oct;9(10):1105-1118.
doi: 10.1002/alr.22398. Epub 2019 Jul 29.

Sinonasal quality-of-life outcomes after endoscopic endonasal skull base surgery

Prashant N Bhenswala  1 , Rodney J Schlosser  1   2 , Shaun A Nguyen  1 , Suqrat Munawar  1 , Nicholas R Rowan  3
Affiliations
Review

Sinonasal quality-of-life outcomes after endoscopic endonasal skull base surgery

Prashant N Bhenswala et al. Int Forum Allergy Rhinol. 2019 Oct.

Abstract

Background: There are substantial gaps in our understanding of the influence of the endoscopic endonasal approach (EEA) for endoscopic skull base surgery on sinonasal-specific quality of life (QOL) as well as the instruments available for assessment. Our primary objective in this study was to characterize postoperative changes in sinonasal QOL, specifically using the 22-item Sino-Nasal Outcome Test (SNOT-22), with a secondary objective of delineating weaknesses in our current understanding of patient symptomatology after EEA for skull base surgery.

Methods: A comprehensive literature review was conducted using PubMed, CINAHL, Cochrane Library, and SCOPUS for studies reporting SNOT-22 data pre- and postoperatively in patients who underwent EEA for skull base pathologies. Studies were limited to patients ≥18 years of age and excluded patients diagnosed with chronic rhinosinusitis (CRS).

Results: Nineteen unique studies with 27 separate data sets and a total of 1025 patients were used in this meta-analysis. Overall SNOT-22 scores statistically improved at the 6-month (p = 0.0009) and 1-year (p = 0.002) time-points. Patients with preoperative SNOT-22 scores ≥20 achieved postoperative improvements at 12-week (p < 0.00001), 6-month (p < 0.0001), 1-year (p < 0.00001), and long-term follow-up (p < 0.0001). Patients with preoperative SNOT-22 scores <20 remained stable and did not worsen postoperatively.

Conclusion: Patients undergoing EEA for skull base pathologies who have impaired sinonasal QOL preoperatively demonstrated significant postoperative QOL improvements. Those patients with relatively normal preoperative sinonasal QOL remained asymptomatic postoperatively. This study supports the need for development of a contemporary disease- and approach-specific, validated QOL instrument for skull base pathologies.

Keywords: anterior skull base; outcome measures; patient reported outcome measures; pituitary neoplasms; quality of life; skull base neoplasms.

PubMed Disclaimer

References

    1. Miller JD, Taylor RJ, Ambrose EC, Laux JP, Ebert CS, Zanation AM. Complications of open approaches to the skull base in the endoscopic era. J Neurol Surg B Skull Base. 2017;78:11-17.
    1. Moussazadeh N, Prabhu V, Bander ED, et al. Endoscopic endonasal versus open transcranial resection of craniopharyngiomas: a case-matched single-institution analysis. Neurosurg Focus. 2016;41:E7.
    1. Eloy JA, Vivero RJ, Hoang K, et al. Comparison of transnasal endoscopic and open craniofacial resection for malignant tumors of the anterior skull base. Laryngoscope. 2009;119:834-840.
    1. Nicolai P, Battaglia P, Bignami M, et al. Endoscopic surgery for malignant tumors of the sinonasal tract and adjacent skull base: a 10-year experience. Am J Rhinol. 2008;22:308-316.
    1. Abergel A, Cavel O, Margalit N, Fliss DM, Gil Z. Comparison of quality of life after transnasal endoscopic vs open skull base tumor resection. Arch Otolaryngol Head Neck Surg. 2012;138:142-147.