Prospective validation of a patient-reported nasal quality-of-life tool for endonasal skull base surgery: The Anterior Skull Base Nasal Inventory-12

Little, Andrew S.; Kelly, Daniel F.; Milligan, John; Griffiths, Chester F; Rosseau, Gail; Prevedello, Daniel M.; Carrau, Ricardo L.; Jahnke, Heidi; Chaloner, Charlene; O'Leary, Judith; Chapple, Kristina; Nakaji, Peter; White, William L.

doi:10.3171/2013.3.jns122032

Cited by 47 publications

(53 citation statements)

References 24 publications

(33 reference statements)

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“…Endoscopic cases had a better rhinological outcome. Hong et al compared outcomes of patients undergoing unilateral microscopic and bilateral endoscopic surgery using the ASK nasal inventory, a derivative of the recently introduced ASK Nasal‐12; microsurgical cases showed better scores 3 months after surgery . Here, a further follow‐up would be necessary.…”

Section: Discussionmentioning

confidence: 99%

“…Hong et al compared outcomes of patients undergoing unilateral microscopic and bilateral endoscopic surgery using the ASK nasal inventory, a derivative of the recently introduced ASK Nasal-12; microsurgical cases showed better scores 3 months after surgery. [17][18][19] Here, a further follow-up would be necessary. In another comparative study of microscopical and bilateral endoscopical surgery, Pledger et al found no significant difference between the late postoperative SNOT-20 scores.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic unilateral transethmoid‐paraseptal approach to the central skull base

Eördögh

Briner

Simmen

et al. 2017

Laryngoscope Investig Oto

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ObjectivesThe endoscopic technique in transnasal skull base surgery offers optimal visualization and free manipulation in the surgical field. However, it may cause approach‐related sinonasal injury, influencing patients' quality of life (QOL). To minimize rhinological morbidity without restrictions in surgical manipulation and tumor resection, we introduced the unilateral transethmoidal‐paraseptal approach. In this article, we analyzed the long‐term results and sinonasal outcome of this technique.Study DesignRetrospective analysis of medical records.MethodsForty‐two consecutive patients underwent surgery between June 2010 and March 2014 using the transethmoid‐paraseptal approach. Perioperative work‐up included neurological, radiological, endocrinological, ophthalmological, and rhinological analysis. Patients' preoperative, 1‐month and 1‐year postoperative QOL was measured using the Sino‐Nasal Outcome Test (SNOT‐22).ResultsAt all individuals, a unilateral transethmoid‐paraseptal approach was performed. Removal of the turbinates, posterior septal resection or a conversion to biportal surgery could be avoided in all cases. There were no intraoperative neurovascular complications. All patients had a notable improvement in any disease‐related symptoms, as well as by objective criteria. Complete tumor resection was aimed in 39 cases and achieved in 31 of them. The SNOT‐22 scores transiently worsened 1 month after surgery and non‐significantly improved after 1 year, compared with the preoperative status. A subgroup of 7 patients with preoperative sinonasal disease evidence showed continuous significant improvement (p < .05) of SNOT‐22 scores across time. The smell screening tests showed no significant difference across time.ConclusionThe described approach allows safe removal of various skull base lesions without deterioration in sinonasal QOL and smell function.Level of Evidence4.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic unilateral transethmoid‐paraseptal approach to the central skull base

Eördögh

Briner

Simmen

et al. 2017

Laryngoscope Investig Oto

View full text Add to dashboard Cite

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“…12 Secondary supplementary end points included health status estimated by patient scores on the 8-item Short-Form Health Survey (SF-8) at the same time points and sinus endoscopy findings performed at various times after surgery. 17 The presence or absence and severity of mucopurulence, synechia, and crusting were recorded during nasal endoscopy.…”

Section: Study End Pointsmentioning

confidence: 99%

Predictors of sinonasal quality of life and nasal morbidity after fully endoscopic transsphenoidal surgery

Little

Kelly

Milligan

et al. 2015

JNS

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OBJECT Despite the increasing application of endoscopic transsphenoidal surgery for pituitary lesions, the prognostic factors that are associated with sinonasal quality of life (QOL) and nasal morbidity are not well understood. The authors examine the predictors of sinonasal QOL and nasal morbidity in patients undergoing fully endoscopic transsphenoidal surgery. METHODS An exploratory post hoc analysis was conducted of patients who underwent endoscopic pituitary surgery and were enrolled in a prospective multicenter QOL study. End points of the study included patient-reported sinonasal QOL and objective nasal endoscopy findings. Multivariate models were developed to determine the patient and surgical factors that correlated with QOL at 2 weeks through 6 months after surgery. RESULTS This study is a retrospective review of a subgroup of patients studied in the clinical trial “Rhinological Outcomes in Endonasal Pituitary Surgery” (clinical trial no. NCT01504399, clinicaltrials.gov). Data from 100 patients who underwent fully endoscopic transsphenoidal surgery were included. Predictors of a lower postoperative sinonasal QOL at 2 weeks were use of nasal splints (p = 0.039) and female sex at the trend level (p = 0.061); at 3 months, predictors of lower QOL were the presence of sinusitis (p = 0.025), advancing age (p = 0.044), and use of absorbable nasal packing (p = 0.014). Health status (multidimensional QOL) was also predictive at 2 weeks (p = 0.001) and 3 months (p < 0.001) and was the only significant predictor of sinonasal QOL at 6 months (p < 0.001). A Kaplan-Meier analysis was performed to study time to resolution of nasal crusting, mucopurulence, and synechia as observed during nasal endoscopy after surgery. The mean time (± SEM) to absence of nasal crusting was 16.3 ± 2.1 weeks, mucopurulence was 6.2 ± 1.1 weeks, and synechia was 4.4 ± 0.5 weeks. Use of absorbable nasal packing was associated with more severe mucopurulence. CONCLUSIONS Sinonasal QOL following endoscopic pituitary surgery reaches a nadir at 2 weeks and recovers by 3 months postoperatively. Use of absorbable packing and nasal splints, while used in a minority of patients, negatively correlates with early sinonasal QOL. Sinonasal QOL and overall health status are well correlated in the postoperative period, suggesting the important influence of sinonasal QOL on the patient experience.

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“…23 Secondary supplementary end points included health status estimated by patient scores on the 8-Item Short Form Health Survey (SF-8). 7,32 The EuroQol (EQ)-5D-5L was also administered to patients at the lead site.…”

Section: Study End Pointsmentioning

confidence: 99%

Comparison of sinonasal quality of life and health status in patients undergoing microscopic and endoscopic transsphenoidal surgery for pituitary lesions: a prospective cohort study

Little

Kelly

Milligan

et al. 2015

JNS

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obJect Despite the widespread adoption of endoscopic transsphenoidal surgery for pituitary adenomas, the sinonasal quality of life (QOL) and health status in patients who have undergone this technique have not been compared with these findings in patients who have undergone the traditional direct uninostril microsurgical technique. In this study, the authors compared the sinonasal QOL and patient-reported health status after use of these 2 surgical techniques. methods The study design was a nonblinded prospective cohort study. Adult patients with sellar pathology and planned transsphenoidal surgery were screened at 4 pituitary centers in the US between October 2011 and August 2013. The primary end point of the study was postoperative patient-reported sinonasal QOL as measured by the Anterior Skull Base Nasal Inventory-12 (ASK Nasal-12). Supplementary end points included patient-reported health status estimated by the 8-Item Short Form Health Survey (SF-8) and EuroQol (EQ)-5D-5L instruments, and sinonasal complications. Patients were followed for 6 months after surgery. results A total of 301 patients were screened and 235 were enrolled in the study. Of these, 218 were analyzed (111 microsurgery patients, 107 endoscopic surgery patients). Demographic and tumor characteristics were similar between groups (p ≥ 0.12 for all comparisons). The most common complication in both groups was sinusitis (7% in the microsurgery group, 13% in the endoscopic surgery group; p = 0.15). Patients treated with the endoscopic technique were more likely to have postoperative nasal debridements (p < 0.001). The ASK Nasal-12 and SF-8 scores worsened substantially for both groups at 2 weeks after surgery, but then returned to baseline at 3 months. At 3 months after surgery, patients treated with endoscopy reported statistically better sinonasal QOL compared with patients treated using the microscopic technique (p = 0.02), but there were no significant differences at any of the other postoperative time points. coNclusioNs This is the first multicenter study to examine the effect of the transsphenoidal surgical technique on sinonasal QOL and health status. The study showed that surgical technique did not significantly impact these patientreported measures when performed at high-volume centers.Clinical trial registration no.: NCT01504399 (clinicaltrials.gov).http://thejns.org/doi/abs

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Prospective validation of a patient-reported nasal quality-of-life tool for endonasal skull base surgery: The Anterior Skull Base Nasal Inventory-12

Cited by 47 publications

References 24 publications

Endoscopic unilateral transethmoid‐paraseptal approach to the central skull base

Endoscopic unilateral transethmoid‐paraseptal approach to the central skull base

Predictors of sinonasal quality of life and nasal morbidity after fully endoscopic transsphenoidal surgery

Comparison of sinonasal quality of life and health status in patients undergoing microscopic and endoscopic transsphenoidal surgery for pituitary lesions: a prospective cohort study

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