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

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.

Chinese abstract

背景：尽管颅底肿瘤内镜鼻内入路（EEA）对鼻窦生活质量（QOL）有良好的预后, 但影响QOL的因素是什么仍是个问题。

目的：探讨EEA治疗前颅底肿瘤后, 鼻腔QOL的恢复情况及预后因素。

材料与方法：本研究选取250例3年多来接受EEA的前颅底肿瘤患者。通过鼻腔结果测试（SNOT-22）评价鼻腔6个月的生活质量。分析了年龄、性别、既往手术、手术程度、肿瘤病理、联合手术及手术并发症。

结果：男性101例, 女性149例, 平均年龄48.6±16.1岁。SNOT-22从基线（中位数17.0；Q₁–Q₃ 8.25-30.0）增加到术后1个月和3个月（分别为27.0；15.0-36.0；p<0.001和20.5；11.0-32.0；p=0.021）, 并在6个月内恢复到基线。调整基线评分和术后月数后, 钙羟基磷灰石重建和术后粘膜水肿对恢复有负面影响（分别为P=0.016和0.010）。

结论与意义：鼻腔QOL在6个月内恢复。避开钙羟基磷灰石可以防止延迟恢复。外科医生应小心操作鼻粘膜, 以尽量减少术后粘膜水肿。

Keywords:

• Quality of life
• skull base neoplasms
• minimally invasive surgical procedure
• endoscopy

Disclosure statement

The authors declare that they have no conflict of interest and there was no financial support for this study.