© Thieme Medical Publishers
Evolution of Sinonasal Symptoms Following Endoscopic Anterior Skull Base Surgery
11 March 2010 (online)
To assess the severity and evolution of sinonasal symptoms in patients following endoscopic anterior skull base surgery to define the typical postoperative course. Design: Cross sectional study. Participants include 69 patients who underwent endoscopic skull base surgery by a dual surgeon team (otolaryngologist and neurosurgeon) from January 2008 to August 2009. Main outcome measures: Sinonasal Outcomes Test (SNOT)-20 survey scores at preoperative and at three postoperative time points. An ordinal logistic regression model was used to analyze the data, summarizing the relationship between the outcome (SNOT score) and the predictor (time point) using an odds ratio. Scores for the symptoms of need to blow nose, sneezing, runny nose, postnasal discharge, thick nasal discharge, ear fullness, and facial pain showed significant worsening at the early postoperative time point. These symptoms showed significant improvement over time; however, scores for post nasal discharge remained high at the late time period compared with baseline. All patients will experience considerable sinonasal symptoms following transnasal endoscopic skull base surgery. Postnasal discharge and thick nasal discharge improve significantly over time. Symptoms approach baseline by 6 to 9 months following surgery.
Skull base - sinonasal - endoscopic - sinus surgery
- 1 Liu J K, Das K, Weiss M H, Laws Jr E R, Couldwell W T. The history and evolution of transsphenoidal surgery. J Neurosurg. 2001; 95 1083-1096
- 2 Jho H D, Carrau R L, Ko Y, Daly M A. Endoscopic pituitary surgery: an early experience. Surg Neurol. 1997; 47 213-222, discussion 222–223
- 3 Senior B A, Ebert C S, Bednarski K K et al.. Minimally invasive pituitary surgery. Laryngoscope. 2008; 118 1842-1855
- 4 Sethi D S, Leong J L. Endoscopic pituitary surgery. Otolaryngol Clin North Am. 2006; 39 563-583, x
- 5 Poetker D M, Smith T L. Adult chronic rhinosinusitis: surgical outcomes and the role of endoscopic sinus surgery. Curr Opin Otolaryngol Head Neck Surg. 2007; 15 6-9
- 6 Bhattacharyya N. Clinical outcomes after endoscopic sinus surgery. Curr Opin Allergy Clin Immunol. 2006; 6 167-171
- 7 Smith T L, Mendolia-Loffredo S, Loehrl T A, Sparapani R, Laud P W, Nattinger A B. Predictive factors and outcomes in endoscopic sinus surgery for chronic rhinosinusitis. Laryngoscope. 2005; 115 2199-2205
- 8 Piccirillo J F, Merritt Jr M G, Richards M L. Psychometric and clinimetric validity of the 20-item Sinonasal Outcome Test (SNOT-20). Otolaryngol Head Neck Surg. 2002; 126 41-47
Ashley E Balaker, M.D.
Division of Head and Neck Surgery, University of California Los Angeles David Geffen School of Medicine
10833 Le Conte Avenue, CHS Rm 62-132, Los Angeles, CA 90095