title: Patient-reported nasal morbidity following endoscopic endonasal skull base surgery.
abstract: OBJECTIVE
  To quantify the frequency and severity of nasal morbidity following endoscopic endonasal skull base surgery using patient-reported outcome measures.
  
  
  METHODS
  Retrospective review and follow-up of all patients who underwent endoscopic endonasal skull base surgery at University Hospital Southampton between January 2007 and December 2011. Demographic data were collated from case notes and patients were asked a standardised questionnaire by telephone interview. Statistical sub-analysis of pituitary and other anterior skull base pathology groups was performed using SPSS 1.8.
  
  
  RESULTS
  Out of 151 included patients, 85 had a pituitary pathology and the remaining had other anterior skull base pathologies. The mean age was 55.2 years, with 75 male and 76 female patients. Totally 124 patients were interviewed with a median follow-up of 15 months. Mild or no nasal crusting was reported by 77% of patients. In those experiencing crusting, more than 50% resolved within 4 weeks. The majority of patients reported no nasal blockage (52%), pain (83%) or nasal discharge (57%) post-operatively. Totally 71% reported no change in sense of smell post-operatively. The only statistically significant difference between the two pathology groups was that surgery on other anterior skull base pathology was associated with an increased rate of developing anosmia (p = 0.02).
  
  
  CONCLUSIONS
  Endoscopic endonasal skull base surgery is associated with a low level of patient-reported post-operative nasal morbidity. There is no significant difference in frequency of crusting, blockage, pain or discharge between pituitary and other anterior skull base pathology groups. However, anterior skull base surgery would appear to be associated with an increased rate of anosmia post-operatively.
authors.affiliation: Department of Neurosurgery, Wessex Neurological Centre, University Hospitals Southampton , Southampton , UK.
authors.forename: Mathew Joseph
authors.initials: MJ
authors.lastname: Gallagher
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Durnford
authors.forename: Salima Sofia
authors.initials: SS
authors.lastname: Wahab
authors.forename: Salil
authors.initials: S
authors.lastname: Nair
authors.forename: Ashok
authors.initials: A
authors.lastname: Rokade
authors.forename: Nijaguna
authors.initials: N
authors.lastname: Mathad
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D044583:Neuroendoscopy; D009666:Nose / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D019291:Skull Base / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000601:surgery; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: endoscopy; minimally invasive surgery; pituitary surgery; skull base tumours; surgical approach