title: Global and disease-specific health-related quality of life after complete endoscopic resection of anterior skull base neoplasms.
abstract: BACKGROUND
  Minimally invasive surgery for neoplasms of the anterior skull base has revolutionized the treatment of these diseases. The relative effect of endoscopic procedures, however, has not been described in terms of disease-specific and global health-related quality  of life (QoL).
  
  
  METHODS
  A single-center longitudinal study was performed of patients undergoing complete endoscopic resection of anterior skull base neoplasms. Patients presenting between October 2009 and September 2010 were enrolled. QoL assessments were based on the 22-question  Sinonasal Outcomes Test (SNOT-22), Health Utilities Index Mark II (HUI-2), and Short-Form 12 (SF-12) and were completed preoperatively and at 3, 6, and 12 months postoperatively. Comparisons over time were made within subjects.
  
  
  RESULTS
  Fourteen patients were enrolled;  11 completed preoperative and postoperative assessments (79%). Our cohort consisted of five men and six women; mean age was 55 years. Six patients had malignant tumors; four required adjuvant therapy. SNOT-22 scores were stable or improved in 10 cases (91%), with a significant difference for  the cohort (mean, -33 points; p < 0.01). Ten (91%) patients had stable or improved HUI-2 scores (mean utility change, +0.13). SF-12 scores were stable for both mental (p = 0.17) and physical (p = 0.26) components. Mean quality-adjusted life year gain over the study period was 0.07.
  
  
  CONCLUSIONS
  Complete endoscopic resection of anterior skull base neoplasms is oncologically sound with anecdotal QoL improvements relative to open craniofacial resection. We show positive, quantifiable QoL results with validated global and disease-specific instruments. Additional  work will help to improve outcomes in this population and will be used in formal cost-effectiveness analysis.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Evan R
authors.initials: ER
authors.lastname: Ransom
authors.forename: Laurel
authors.initials: L
authors.lastname: Doghramji
authors.forename: James N
authors.initials: JN
authors.lastname: Palmer
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Chiu
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011788:Quality of Life; D019292:Skull Base Neoplasms / Q000473:pathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome