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
