title: Long-term changes in quality of life after endoscopic resection of sinonasal and skull-base tumors.
abstract: BACKGROUND
  Minimally invasive endoscopic resection (MIER) has emerged as the new standard for surgical treatment of sinonasal and skull-base tumors. The objective of the present study was to evaluate quality of life (QOL) 2 years after MIER.
  
  
  METHODS
  Prospective 20-item Sino-Nasal Outcome Test (SNOT-20) data was accrued on 104 patients over 4 years. The study cohort included 72 patients with sinonasal malignancy, while 32 patients with inverted papilloma (IP) served as controls.
  
  
  RESULTS
  The overall and rhinologic subdomain SNOT-20 scores for cancer patients did not statistically improve at 2 years (p = 0.12). They had statistically significant improvement in the psychological subdomain scores at 1 year (p = 0.03) and 2 years (p = 0.03). Similarly, the sleep subdomain scores improved at 1 year (p = 0.04) and 2 years (p = 0.03). In contrast, IP patients had statistically significant improvement in overall SNOT-20 (p = 0.01), rhinologic (p = 0.01), and sleep (p = 0.05) subdomain scores at 6 months, which remained stable at 2 years. Analysis of various factors demonstrated that history of prior smoking adversely affected QOL scores in cancer patients, with higher total SNOT-20 scores than nonsmokers (p = 0.01). Smokers also had higher psychological (p = 0.04), sleep (p = 0.01), and ear/facial (p = 0.001) domain scores than nonsmokers at 2 years.
  
  
  CONCLUSIONS
  The long-term effects of MIER for sinus cancer showed improved psychological and sleep scores at both 1 year and 2 years. Unfortunately, rhinologic QOL did not statistically improve at any of the measured time points. History of smoking was noted to be the most important predictor of QOL 2 years after MIER for sinonasal malignancy.
authors.affiliation: University of Texas Southwestern Medical School, Dallas, TX.
authors.forename: Taylor
authors.initials: T
authors.lastname: Derousseau
authors.affiliation: University of Texas Southwestern Medical School, Dallas, TX.
authors.forename: Lakshman
authors.initials: L
authors.lastname: Manjunath
authors.affiliation: University of Texas Southwestern Medical School, Dallas, TX.
authors.forename: Brian
authors.initials: B
authors.lastname: Harrow
authors.affiliation: Department of Clinical Science, UT Southwestern Medical Center, Dallas, TX.
authors.forename: Song
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, IL.
authors.forename: Pete S
authors.initials: PS
authors.lastname: Batra
mesh_terms: D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000601:surgery*; D018308:Papilloma, Inverted / Q000601:surgery*; D010256:Paranasal Sinuses / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D019292:Skull Base Neoplasms / Q000601:surgery*; D012907:Smoking; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: MIER; neoplasm; quality of life; sinonasal; sinus; skull base; tumor