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A prospective study of postoperative symptoms in sinonasal quality‐of‐life following endoscopic skull‐base surgery: dissociations based on specific symptoms
Author(s) -
Bedrosian Jeffrey C.,
McCoul Edward D.,
Raithatha Roheen,
Akselrod Olga A.,
Anand Vijay K.,
Schwartz Theodore H.
Publication year - 2013
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21161
Subject(s) - medicine , surgery , prospective cohort study , taste , quality of life (healthcare) , pituitary adenoma , nose , nasal administration , skull , anesthesia , adenoma , chemistry , food science , nursing , immunology
Background Endoscopic skull‐base surgery (ESBS) is a minimal access approach to cranial base pathology; however, it significantly disrupts the intranasal mucosa and intranasal structures, the long‐term effects of which are still being studied. We prospectively assessed postoperative changes in sinonasal QOL symptoms following ESBS. Methods Eighty‐five patients were prospectively assessed with the Anterior Skull Base Questionnaire (ASBQ), a validated QOL instrument, preoperatively and up to 1 year postoperatively at each subsequent office visit. A subset of these data was analyzed to assess the effect of endoscopic pituitary surgery on postoperative taste, smell, appetite, nasal secretions, and vision. Results ESBS patients were divided into 2 cohorts: those undergoing pituitary adenoma surgery and those undergoing ESBS for all other pathologies. Preoperative smell (3.11 vs 3.76, p = 0.03) and taste (3.04 vs 3.69, p = 0.03) were significantly lower in the nonpituitary group. Within the pituitary group both taste (3.69 vs 2.95, p = 0.03) and smell (3.76 vs 2.61, p ≤ 0.001) were significantly decreased by 6 weeks postoperatively. However, by 12 months both taste and smell scores returned to baseline. Vision scores improved by 3 weeks postoperatively with durable results at 1 year (2.80 vs 3.33, p = 0.04 vs 3.59, p = 0.03, respectively). Within the nonpituitary group, smell was decreased at 3 weeks, but was not significantly changed at any other time points. Conclusion Our study indicates a dissociation between the nasal and visual QOL after ESBS. While nasal QOL transiently decreases, visual QOL progressively improves. These data should not be lumped together for the purposes of statistical analysis.