title: Sinonasal quality of life outcomes after minimally invasive resection of sinonasal and skull-base tumors.
abstract: BACKGROUND
  Minimally invasive endoscopic resection (MIER) has emerged as the standard for surgical management of benign and malignant sinonasal and skull-base neoplasms. The objective of the present study was to assess sinonasal quality of life (QOL) and to analyze factors that impact symptomatology after surgery.
  
  
  METHODS
  This single-institution observational cohort study was performed on 94 patients over a 3-year period.
  
  
  RESULTS
  The mean age was 55.2 years, with male:female ratio of 1.5:1. Benign and malignant tumors were observed in 48% and 52% of patients, respectively. The cohort's mean preoperative 20-item Sino-Nasal Outcomes Test score (SNOT-20) was 1.27, decreasing to 0.91 (p = 0.002) at 6 months postoperatively. Patients with benign neoplasms had a lower mean preoperative SNOT-20 score of 1.11 that decreased to 0.58 (p = 0.002), whereas patients with malignant tumors had a higher mean preoperative SNOT-20 score of 1.27, decreasing to 1.03 (p = 0.134) at 6 months postoperatively. The SNOT-20 scores for females improved 0.53 (p = 0.002) compared to 0.23 (p = 0.154) for males at 6 months. Statistically significant sinonasal QOL improvement was noted in nonsmokers (0.62, p = 0.0006), patients with no prior radiation or chemotherapy (0.59, p = 0.0029), and patients with no prior surgery (0.51, p = 0.0012). Multiple variable regression analysis demonstrated that the 2 strongest predictors for lack of SNOT-20 improvement were previous history of smoking (p < 0.05) and prior radiation and/or chemotherapy (p < 0.01) (R(2) = 0.24).
  
  
  CONCLUSIONS
  MIER results in overall improvement in SNOT-20 scores, with greater change being noted in females and in patients with benign tumors. Prior smoking and chemoradiation strongly predict decreased improvement in sinonasal QOL after surgery.
authors.affiliation: University of Texas Southwestern Medical School, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Harrow
authors.forename: Pete S
authors.initials: PS
authors.lastname: Batra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009669:Nose Neoplasms / Q000601:surgery*; D010256:Paranasal Sinuses / Q000601:surgery*; D011788:Quality of Life; D012307:Risk Factors; D019292:Skull Base Neoplasms / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: endoscopy; neoplasm; quality of life; sinus; skull base; tumors