J Neurol Surg B
DOI: 10.1055/s-0039-1694010
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Prospective Evaluation of Health-Related Quality of Life in Patients Undergoing Anterolateral Craniofacial Resection with Orbital Exenteration

Nobuaki Mukoyama*
1  Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
1  Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
2  Department of Otolaryngology, Stanford University, Stanford, California, United States
,
Hiroyuki Kimura
3  Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Shinichi Kishi
3  Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Tatsuya Tokura
3  Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Hiroki Kimura
3  Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Mariko Hiramatsu
1  Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Takashi Maruo
1  Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Hidenori Tsuzuki
1  Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Masazumi Fujii
4  Department of Neurosurgery, Fukushima Medical University, Fukushima, Japan
,
Kenichiro Iwami
5  Department of Neurosurgery, Aichi Medical University, Aichi, Japan
,
Keisuke Takanari
6  Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Yuzuru Kamei
6  Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Norio Ozaki
3  Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Michihiko Sone
1  Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
,
Yasushi Fujimoto
1  Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
› Author Affiliations
Further Information

Publication History

09 February 2019

28 May 2019

Publication Date:
24 July 2019 (online)

Abstract

Objective This study was aimed to evaluate health-related quality of life in patients undergoing anterolateral craniofacial resection (AL-CFR) with orbital exenteration (OE) for malignant skull base tumors and to investigate the effects of early psychiatric intervention.

Design Present study is a prospective, observational study.

Setting The study took place at the hospital department.

Participants Twenty-six consecutive patients were selected who underwent AL-CFR with OE at our hospital between 2005 and 2015.

Main Outcome Measures Health-related quality of life was assessed preoperatively and 3, 6, 12, and 24 months after surgery using the Hospital Anxiety and Depression Scale (HADS) and medical outcomes study 8-items Short Form health survey (SF-8). In all cases, psychiatric intervention was organized by the consultation liaison psychiatry team preoperatively and postoperatively.

Results Ten (38.0%) of the 26 patients died and 16 (62.0%) were alive and disease-free at the end of the study. The 3-year overall and disease-free survival rates were 64.9% and 53.3%, respectively. Twenty-one patients (80.8%) developed psychiatric complications after surgery and needed treatment with psychotropic medication. Before surgery, 28% of patients had HADS scores ≥8 for anxiety and 20% had scores ≥8 for depression. Seven of the eight items in the SF-8 were significantly lower than those for the general Japanese population. However, scores for all the SF-8 items gradually improved during postoperative follow-up, reaching approximately 50 points, which is the national standard value, at 2 years after surgery.

Conclusions Craniofacial resection with OE was feasible and well tolerated in patients with malignant skull base tumors who received early psychiatric intervention to decrease the considerable psychological impact of this procedure.

* These authors contributed equally to this work.