Recovery period of sinonasal quality of life and its associated factors after endoscopic endonasal approach for anterior skull base tumors

Acta Otolaryngol. 2019 May;139(5):461-466. doi: 10.1080/00016489.2019.1574982. Epub 2019 Feb 26.

Abstract

Background: Although endoscopic endonasal approach (EEA) for skull base tumors showed a good prognosis in sinonasal quality of life (QOL), what factors have influence on QOL is still in question. Aim/Objectives: To investigate the recovery of sinonasal QOL after EEA for anterior skull base tumors and find its prognostic factors.

Material and methods: The study enrolled 250 patients undergoing EEA for anterior skull base tumors over 3 years. Sinonasal QOL was evaluated via sinonasal outcome test (SNOT-22) during 6 months. Age, gender, previous surgery, surgical extent, tumor pathology, combined surgical procedures, and surgical complications were analyzed.

Results: There were 101 male and 149 female with average 48.6 ± 16.1 years old. SNOT-22 increased from baseline (median 17.0; Q1-Q3 8.25-30.0) to postoperative 1 and 3 months (27.0; 15.0-36.0; p < .001 and 20.5; 11.0-32.0; p = .021, respectively) and it returned to the baseline within 6 months. Reconstruction with calcium hydroxyapatite and postoperative mucosal edema had a negative impact on the recovery (p = .016 and .010, respectively), after adjustment for the baseline scores and postoperative months.

Conclusions and significance: Sinonasal QOL was recovered within 6 months. Avoidance of calcium hydroxyapatite could prevent delayed recovery. Surgeons should carefully manipulate nasal mucosa to minimize postoperative mucosal edema.

Keywords: Quality of life; endoscopy; minimally invasive surgical procedure; skull base neoplasms.

MeSH terms

  • Adenoma / surgery*
  • Adult
  • Aged
  • Durapatite
  • Female
  • Humans
  • Male
  • Middle Aged
  • Natural Orifice Endoscopic Surgery / rehabilitation*
  • Pituitary Neoplasms / surgery*
  • Plastic Surgery Procedures
  • Quality of Life
  • Retrospective Studies
  • Skull Base Neoplasms / surgery*
  • Young Adult

Substances

  • Durapatite