Quality of Life Following Endoscopic Resection of Skull Base Tumors

Abstract

The objective of the study is to evaluate patients' quality of life (QOL) after endoscopic resection of skull base tumors. We estimated the QOL of 41 patients who underwent surgery for removal of skull base tumors via the expanded endonasal approach (EEA). The Anterior Skull Base Surgery Questionnaire (ASBS-Q), a multidimensional, disease-specific instrument containing 36 items was used. The rate of meningitis and cerebrospinal fluid leak was 1.4 and 0%, respectively. There was one case of uniocular visual impairment. The internal consistency of the instrument had a correlation coefficient (α-Cronbach score) of 0.8 to 0.92. Of 41 patients, 30 (75%) reported improvement or no change in overall QOL. Improved scores were reported in the physical function domain and worse scores in the specific symptoms domain. The most significant predictor of poor QOL was female gender, which led to a significant decrease in scores of all domains. Site of surgery, histology, age and comorbidity were not significant predictors of outcome. This paper further validates the use of the ASBS-Q for patients undergoing endoscopic skull base resection. The overall QOL of patients following endoscopic extirpation of skull base tumors is good. Female patients experience a significant decline in QOL compared with males.

Keywords

quality of life - endoscopy - morbidity - skull base - sinuses - craniofacial

• References

• 1 Gil Z, Fliss DM. Quality of life in patients with skull base tumors: current status and future challenges. Skull Base 2010; 20 (1) 11-18
• 2 Gil Z, Abergel A, Spektor S, Shabtai E, Khafif A, Fliss DM. Development of a cancer-specific anterior skull base quality-of-life questionnaire. J Neurosurg 2004; 100 (5) 813-819
• 3 Gil Z, Fliss DM. Contemporary management of head and neck cancers. Isr Med Assoc J 2009; 11 (5) 296-300
• 4 Snyderman CH, Kassam AB, Carrau R, Mintz A. Endoscopic Reconstruction of Cranial Base Defects following Endonasal Skull Base Surgery. Skull Base 2007; 17 (1) 73-78
• 5 Wasserzug O, Margalit N, Weizman N, Fliss DM, Gil Z. Utility of a three-dimensional endoscopic system in skull base surgery. Skull Base 2010; 20 (4) 223-228
• 6 Witgert ME, Veramonti T, Hanna E. Instruments for estimation of health-related quality of life in patients with skull base neoplasms. Skull Base 2010; 20 (1) 5-10
• 7 Hanna E, DeMonte F, Ibrahim S, Roberts D, Levine N, Kupferman M. Endoscopic resection of sinonasal cancers with and without craniotomy: oncologic results. Arch Otolaryngol Head Neck Surg 2009; 135 (12) 1219-1224
• 8 Gil Z, Abergel A, Spektor S , et al. Quality of life following surgery for anterior skull base tumors. Arch Otolaryngol Head Neck Surg 2003; 129 (12) 1303-1309
• 9 Gil Z, Abergel A, Spektor S, Khafif A, Fliss DM. Patient, caregiver, and surgeon perceptions of quality of life following anterior skull base surgery. Arch Otolaryngol Head Neck Surg 2004; 130 (11) 1276-1281
• 10 Snyderman CH, Kassam AB. Endoscopic techniques for pathology of the anterior cranial fossa and ventral skull base. J Am Coll Surg 2006; 202 (3) 563
• 11 Gil Z, Patel SG, Bilsky M, Shah JP, Kraus DH. Complications after craniofacial resection for malignant tumors: are complication trends changing?. Otolaryngol Head Neck Surg 2009; 140 (2) 218-223
• 12 Abergel A, Fliss DM, Margalit N, Gil Z. A prospective evaluation of short-term health-related quality of life in patients undergoing anterior skull base surgery. Skull Base 2010; 20 (1) 27-33
• 13 Gil Z, Fliss DM. Pericranial wrapping of the frontal bone after anterior skull base tumor resection. Plast Reconstr Surg 2005; 116 (2) 395-398, discussion 399
• 14 Pant H, Bhatki AM, Snyderman CH , et al. Quality of life following endonasal skull base surgery. Skull Base 2010; 20 (1) 35-40
• 15 Palme CE, Irish JC, Gullane PJ, Katz MR, Devins GM, Bachar G. Quality of life analysis in patients with anterior skull base neoplasms. Head Neck 2009; 31 (10) 1326-1334
• 16 Symon Z, Daignault S, Symon R, Dunn RL, Sanda MG, Sandler HM. Measuring patients' expectations regarding health-related quality-of-life outcomes associated with prostate cancer surgery or radiotherapy. Urology 2006; 68 (6) 1224-1229
• 17 Brouwer CN, Schilder AG, van Stel HF , et al. Reliability and validity of functional health status and health-related quality of life questionnaires in children with recurrent acute otitis media. Qual Life Res 2007; 16 (8) 1357-1373
• 18 Patel SG. Internet-Based Multi-institutional Clinical Research: A New Method to Conduct and Manage Quality of Life Studies. Skull Base 2010; 20 (1) 23-26