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Comparison of quality of life and emotional burden after transnasal versus transcranial anterior skull base surgery
EANS Academy. Wagner A. 09/26/19; 276117; EP04098
Dr. Arthur Wagner
Dr. Arthur Wagner

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Abstract
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Objective: To compare differences in psychopathological outcome and health-related quality of life (QOL) between cohorts of patients undergoing transcranial or transnasal anterior skull base surgery.
Methods: A prospective study of patients undergoing elective surgery for various entities of the anterior skull base was performed. Evaluation for depression (ADS-K score) and anxiety (PTSS, STAI-S, STAI-T and ASI-3 scores) were done before surgery, at 3 and 12 months after surgery. Incidence and influence of these psychiatric comorbidities on QOL were examined and compared between transnasal and transcranial subgroups.
Results: Between January 2013 and July 2017, 64 patients undergoing anterior skull base surgery were included, of which 50 (78.1 %) completed follow up interviews after 3 and 12 months. There were 29 (58.0 %) female patients, median age was 57 years. Most common diagnoses were meningioma (46.0 %) and pituitary adenoma (34.0 %). Proportion of pathological anxiety scores significantly decreased from 74.0 % to 46.0 % (p = 0.001), without difference between transnasal and transcranial subgroups (p = 0.432). After 3 months, mean EuroQol VAS score significantly increased by 0.084 (p = 0.02) across the entire cohort without significant difference between transcranial and transnasal subgroups (p = 0.554). The individually declared emotional burden significantly decreased from 6.6 to 4.3 on the ten point Likert scale (p < 0.001) equally for both subgroups (transnasal: -2.15; transcranial: -2.50; p = 0.609). On last examination, about half of the patients in each subgroup (47.6 % vs. 48.3 %; p = 0.963) expressed a clinically significant recovery of preoperative bodily complaints such as headaches, dizziness and unrest.
Conclusion: Our results confirm that both transnasal and transcranial approaches yield comparable postoperative QOL and psychopathological outcomes. Psychological distress in light of an upcoming surgery burdens patients, but psychopathological scores tend to drastically diminish after surgery.
Objective: To compare differences in psychopathological outcome and health-related quality of life (QOL) between cohorts of patients undergoing transcranial or transnasal anterior skull base surgery.
Methods: A prospective study of patients undergoing elective surgery for various entities of the anterior skull base was performed. Evaluation for depression (ADS-K score) and anxiety (PTSS, STAI-S, STAI-T and ASI-3 scores) were done before surgery, at 3 and 12 months after surgery. Incidence and influence of these psychiatric comorbidities on QOL were examined and compared between transnasal and transcranial subgroups.
Results: Between January 2013 and July 2017, 64 patients undergoing anterior skull base surgery were included, of which 50 (78.1 %) completed follow up interviews after 3 and 12 months. There were 29 (58.0 %) female patients, median age was 57 years. Most common diagnoses were meningioma (46.0 %) and pituitary adenoma (34.0 %). Proportion of pathological anxiety scores significantly decreased from 74.0 % to 46.0 % (p = 0.001), without difference between transnasal and transcranial subgroups (p = 0.432). After 3 months, mean EuroQol VAS score significantly increased by 0.084 (p = 0.02) across the entire cohort without significant difference between transcranial and transnasal subgroups (p = 0.554). The individually declared emotional burden significantly decreased from 6.6 to 4.3 on the ten point Likert scale (p < 0.001) equally for both subgroups (transnasal: -2.15; transcranial: -2.50; p = 0.609). On last examination, about half of the patients in each subgroup (47.6 % vs. 48.3 %; p = 0.963) expressed a clinically significant recovery of preoperative bodily complaints such as headaches, dizziness and unrest.
Conclusion: Our results confirm that both transnasal and transcranial approaches yield comparable postoperative QOL and psychopathological outcomes. Psychological distress in light of an upcoming surgery burdens patients, but psychopathological scores tend to drastically diminish after surgery.
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