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J Neurol Surg B Skull Base 2022; 83(S 02): e312-e317
DOI: 10.1055/s-0041-1729976
Original Article

Sinonasal Symptom Outcomes following Endoscopic Anterior Cranial Base Surgery in the Pediatric Population

Taylor R. Carle
1   Department of Head and Neck Surgery, University of California, Los Angeles, Los Angeles, California, United States
,
Vivian Wung
2   David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, United States
,
Anthony P. Heaney
3   Department of Medicine, Endocrinology—Diabetes and Metabolism, University of California, Los Angeles, Los Angeles, California, United States
,
Harvey K. Chiu
4   Department of Pediatrics, Endocrinology, University of California, Los Angeles, Los Angeles, California, United States
,
Jeffrey D. Suh
1   Department of Head and Neck Surgery, University of California, Los Angeles, Los Angeles, California, United States
,
Marvin Bergsneider
5   Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, United States
,
Marilene B. Wang 
1   Department of Head and Neck Surgery, University of California, Los Angeles, Los Angeles, California, United States
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Abstract

Objective This study aimed to evaluate the impact of endoscopic anterior cranial base (ACB) surgery on sinonasal symptoms in the pediatric population utilizing the Sino-Nasal Outcome Test (SNOT)-22 questionnaire.

Design This is a retrospective review.

Setting The study was conducted at a tertiary academic medical center.

Participants Thirty-four consecutive patients, age 6 to 17 years, M:F 14:20, who underwent endoscopic ACB surgery from July 2008 to August 2019. Ten patients had baseline and a minimum of two subsequent postoperative SNOT-22 questionnaires available for analysis.

Main Outcome Measures Baseline and postoperative SNOT-22 scores were compared. The mean change from baseline sinonasal symptom scores in the pediatric and historical adult cohorts was compared.

Results The mean baseline SNOT-22 score for our 10 patient cohort was 0.46 out of 5 for each of the first 10 sinonasal-specific questions. This worsened to 1.69 at 1 month and returned to near baseline, 0.7, at 3 months postoperatively. The mean quality-of-life score improved to 0.91 at 1 month and 0.6 at 3 months postoperatively. The mean change from baseline for the following items: need to blow nose, runny nose, postnasal discharge, thick nasal discharge, wake up at night, reduced concentration, and frustrated/restless/irritable were similar to those in our historical adult cohort at 3 months postoperatively.

Conclusion Endoscopic ACB surgery in the pediatric population results in increased sinonasal symptom morbidity in the early postoperative period; however, symptoms return to near baseline by ∼3 months, and quality-of-life scores progressively improve in the postoperative period. These trends were similar to those seen in our historic adult cohort.

Keywords

skull base - pediatrics - outcomes


Publication History

Received: 23 August 2020

Accepted: 24 February 2021

Article published online:
17 May 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Ali ZS, Lang S-S, Kamat AR. et al. Suprasellar pediatric craniopharyngioma resection via endonasal endoscopic approach. Childs Nerv Syst 2013; 29 (11) 2065-2070
    CrossrefPubMedSearch in Google Scholar
  • 2 Kassam A, Thomas AJ, Snyderman C. et al. Fully endoscopic expanded endonasal approach treating skull base lesions in pediatric patients. J Neurosurg 2007; 106 (2, Suppl): 75-86
    PubMedSearch in Google Scholar
  • 3 Kuan EC, Kaufman AC, Lerner D. et al. Lack of sphenoid pneumatization does not affect endoscopic endonasal pediatric skull base surgery outcomes. Laryngoscope 2019; 129 (04) 832-836
    CrossrefPubMedSearch in Google Scholar
  • 4 Chivukula S, Koutourousiou M, Snyderman CH, Fernandez-Miranda JC, Gardner PA, Tyler-Kabara EC. Endoscopic endonasal skull base surgery in the pediatric population. J Neurosurg Pediatr 2013; 11 (03) 227-241
    CrossrefPubMedSearch in Google Scholar
  • 5 Taşkapılıoğlu MÖ, Yilmazlar S, Eren E, Tarım O, Güler TM. Transnasal transsphenoidal surgical method in pediatric pituitary adenomas. Pediatr Neurosurg 2015; 50 (03) 128-132
    CrossrefPubMedSearch in Google Scholar
  • 6 Yamada S, Fukuhara N, Yamaguchi-Okada M. et al. Therapeutic outcomes of transsphenoidal surgery in pediatric patients with craniopharyngiomas: a single-center study. J Neurosurg Pediatr 2018; 21 (06) 549-562
    CrossrefPubMedSearch in Google Scholar
  • 7 Boghani Z, Husain Q, Kanumuri VV. et al. Juvenile nasopharyngeal angiofibroma: a systematic review and comparison of endoscopic, endoscopic-assisted, and open resection in 1047 cases. Laryngoscope 2013; 123 (04) 859-869
    CrossrefPubMedSearch in Google Scholar
  • 8 Shenouda K, Yuhan BT, Mir A. et al. Endoscopic resection of pediatric skull base tumors: an evidence-based review. J Neurol Surg B Skull Base 2019; 80 (05) 527-539
    Thieme ConnectPubMedSearch in Google Scholar
  • 9 Koumas C, Laibangyang A, Barron SL, Mittler MA, Schneider SJ, Rodgers SD. Outcomes following endoscopic endonasal resection of sellar and supresellar lesions in pediatric patients. Childs Nerv Syst 2019; 35 (11) 2099-2105
    CrossrefPubMedSearch in Google Scholar
  • 10 Alalade AF, Ogando-Rivas E, Boatey J. et al. Suprasellar and recurrent pediatric craniopharyngiomas: expanding indications for the extended endoscopic transsphenoidal approach. J Neurosurg Pediatr 2018; 21 (01) 72-80
    CrossrefPubMedSearch in Google Scholar
  • 11 LoPresti MA, Sellin JN, DeMonte F. Developmental considerations in pediatric skull base surgery. J Neurol Surg B Skull Base 2018; 79 (01) 3-12
    Thieme ConnectPubMedSearch in Google Scholar
  • 12 Morley AD, Sharp HR. A review of sinonasal outcome scoring systems - which is best?. Clin Otolaryngol 2006; 31 (02) 103-109
    CrossrefPubMedSearch in Google Scholar
  • 13 Thompson CF, Suh JD, Liu Y, Bergsneider M, Wang MB. Modifications to the endoscopic approach for anterior skull base lesions improve postoperative sinonasal symptoms. J Neurol Surg B Skull Base 2014; 75 (01) 65-72
    PubMedSearch in Google Scholar
  • 14 Kim JS, Kwon SH. Recurrence of sinonasal inverted papilloma following surgical approach: a meta-analysis. Laryngoscope 2017; 127 (01) 52-58
    CrossrefPubMedSearch in Google Scholar
  • 15 Hopkins C, Gillett S, Slack R, Lund VJ, Browne JP. Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol 2009; 34 (05) 447-454
    CrossrefPubMedSearch in Google Scholar
  • 16 Thamboo A, Santos RCD, Naidoo L, Rahmanian R, Chilvers MA, Chadha NK. Use of the SNOT-22 and UPSIT to appropriately select pediatric patients with cystic fibrosis who should be referred to an otolaryngologist: cross-sectional study. JAMA Otolaryngol Head Neck Surg 2014; 140 (10) 934-939
    CrossrefPubMedSearch in Google Scholar
  • 17 Kay DJ, Rosenfeld RM. Quality of life for children with persistent sinonasal symptoms. Otolaryngol Head Neck Surg 2003; 128 (01) 17-26
    CrossrefPubMedSearch in Google Scholar