Intranasal cross‐sectional area and quality of life changes following endoscopic transsphenoidal skull base surgery

McCoul, Edward D.; Patel, Amit; Bedrosian, Jeffrey C.; Anand, Vijay K.; Schwartz, Theodore H.

doi:10.1002/alr.21602

Cited by 16 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Sinonasal QOL has been shown to deteriorate in the early postoperative period (3–12 weeks after surgery) following EASB with return to baseline 3 to 6 months after surgery. Increases in intranasal cross‐sectional area do not appear to affect sinonasal QOL …”

Section: Discussionmentioning

confidence: 98%

“…Increases in intranasal cross-sectional area do not appear to affect sinonasal QOL. 27 Additional research has focused on QOL outcomes in patients undergoing endoscopic resection of sinonasal tumors without NSF. Harrow et al reported that mean SNOT-20 scores as well as scores for questions corresponding to the rhinologic and ear/facial subdomains were improved at 3 and 6 months after surgery relative to preoperative levels but that the improvement was only found in patients with benign tumors.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long‐term sinonasal outcomes after endoscopic skull base surgery with nasoseptal flap reconstruction

et al. 2018

Self Cite

View full text Add to dashboard Cite

Objectives The utilization of the nasoseptal flap (NSF) in endoscopic anterior skull base surgery (EASB) has resulted in reduced rates of postoperative cerebrospinal fluid leak (CSF). The long‐term impact on sinonasal function after surgery remains incompletely defined. Methods A consecutive series of patients undergoing EASB with NSF and with at least 3 years follow‐up was prospectively evaluated. Patient demographics, pre‐ and postoperative Sino‐nasal Outcome Test‐22 (SNOT‐22) scores, Lund‐Mackay scores (LMS), CSF leak, and sinonasal complications were analyzed. Results A total of 46 patients undergoing EASB with NSF met inclusion criteria. The mean follow‐up was 67.4 months (range 39–90, standard deviation [SD] 14.2 months). No statistically significant differences were noted between the mean overall pre‐ (16) and postoperative SNOT‐22 scores (18). SNOT‐22 scores improved in 27 patients (58.7%), deteriorated in 17 patients (37.0%) and stayed the same in two patients (4.3%). Deterioration in SNOT‐22 scores was greater in younger (mean change + 7.2 [SD17.4] vs. older patients −3.4 [SD 7.5], P = 0.010). A statistically significant increase in LMS was noted (mean preoperative LMS0.9 vs. mean postoperative LMS 2.2, P = 0.001). The LMS decreased in nine patients (19.6%), increased in 22 patients (47.8%), and remained the same in 15 patients (32.6%). One patient (2.2%) developed a postoperative CSF leak following resection of metastatic skull base lesion and was successfully treated with placement of a lumbar drain, Foley catheter balloon, and strict bed rest. One patient (2.2%) developed a postoperative mucocele requiring decompression 3 years after initial surgery. Conclusion Whereas long‐term sinonasal quality of life is overall improved in the majority of patients following NSF use for EASB, younger patients show higher incidence of deterioration. Increased sinus opacification on imaging is generally noted and may require continued follow‐up and management. The incidence of reoperation for symptomatic mucocele formation is low. Level of Evidence 4 Laryngoscope, 129:1035–1040, 2019

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Long‐term sinonasal outcomes after endoscopic skull base surgery with nasoseptal flap reconstruction

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, the contribution of the NSF itself as a risk factor for these sinonasal morbidities after endoscopic endonasal surgery is not known [51]. When nasal patency is measured quantitatively using acoustic rhinometry, the use of the NSF in transsphenoidal surgery did not impact postoperative values, and there was no strong association between the degree of nasal patency and quality of life outcomes to suggest that "empty nose syndrome" causes postoperative obstructive symptoms [57]. Other complications that may occur after skull base surgery include complaints of nasal discharge, nasal obstruction, and anosmia/hyposmia.…”

Section: Donor Site Complicationsmentioning

confidence: 99%

Reconstruction of the Anterior Skull Base Using the Nasoseptal Flap: A Review

Werner,

Yeoh,

Fastenberg

et al. 2023

Cancers

View full text Add to dashboard Cite

The nasoseptal flap is a workhorse reconstructive option for anterior skull base defects during endonasal surgery. This paper highlights the versatility of the nasoseptal flap. After providing a brief historical perspective, this review will focus on the relevant primary literature published in the last ten years. We will touch upon new applications of the flap, how the flap has been modified to expand its reach and robustness, and some of the current limitations. We will conclude by discussing what the future holds for improving upon the design and use of the nasoseptal flap in anterior skull base reconstruction.

show abstract

“…The SNOT-22 has been heavily used in assessing QOL after endonasal skull base surgery, including pituitary surgery. [22][23][24][25] Although we evaluate only the validity and reliability of the SNOT-22 in endoscopic endonasal pituitary surgery in this study, it is an initial and necessary step in improving our understanding and utilization of the optimal questionnaires in these patient populations. Future work should be directed at determining whether the SNOT-22 is an appropriate tool for other endonasal skull base surgery populations (e.g., meningioma, craniopharyngioma, chondrosarcoma, and chordoma).…”

Section: Interpretability and Generalizabilitymentioning

confidence: 99%

Assessment of the Validity of the Sinonasal Outcomes Test‐22 in Pituitary Surgery: A Multicenter Prospective Trial

et al. 2021

View full text Add to dashboard Cite

Objectives/Hypothesis: Sinonasal Outcomes Test-22 (SNOT-22) is used widely as a patient-reported sinonasal qualityof-life (QOL) instrument for endoscopic endonasal pituitary surgery. However, it has never been validated in this population. This study explores the psychometric validity of SNOT-22 to determine if it is a valid scale in patients undergoing endoscopic pituitary surgery.Study Design: Multicenter prospective trial. Methods: Adult patients (n = 113) with pituitary tumors undergoing endoscopic surgery were enrolled in a multicenter study. Patient-reported QOL was assessed using SNOT-22 and the Anterior Skull Base Nasal Inventory-12. Face validity, internal consistency, responsiveness to clinical change, test-retest reliability, and concurrent validity were determined using standard statistical methods.Results: Internal consistency using Cronbach's alpha at baseline and 2 weeks postoperatively were 0.911 and 0.922, indicating SNOT-22 performed well as a single construct. Mean QOL scores were significantly worse at 2 weeks than baseline (16.4 AE 15.1 vs. 23.1 AE 16.4, P < .001), indicating the scale is responsive to clinical change. However, only 11/22 items demonstrated significant changes in mean scores at 2 weeks. Correlation between scores at 2 and 3 weeks was high, suggesting good test-retest reliability, r(107) = 0.75, P < .001. Factor analysis suggests the five-factor solution proposed for the SNOT-22 in rhinosinusitis patients is not valid in pituitary surgery patients.Conclusions: The SNOT-22 is a valid QOL instrument in patients undergoing endoscopic pituitary surgery. However, because it includes 22 items, can be applied only as a single construct, 50% of the items do not demonstrate changes after surgery, and is not as sensitive to change as other scales, shorter instruments developed specifically for this patient population may be preferable.

show abstract

Intranasal cross‐sectional area and quality of life changes following endoscopic transsphenoidal skull base surgery

Abstract: The endoscopic transsphenoidal approach to the skull base can result in increased intranasal area without a detrimental effect on sinonasal QOL. These effects are independent of nasoseptal flap harvest and correction of nasal septal deviation.

Cited by 16 publications

References 18 publications

Long‐term sinonasal outcomes after endoscopic skull base surgery with nasoseptal flap reconstruction

Long‐term sinonasal outcomes after endoscopic skull base surgery with nasoseptal flap reconstruction

Reconstruction of the Anterior Skull Base Using the Nasoseptal Flap: A Review

Assessment of the Validity of the Sinonasal Outcomes Test‐22 in Pituitary Surgery: A Multicenter Prospective Trial

Contact Info

Product

Resources

About