Recovery period of sinonasal quality of life and its associated factors after endoscopic endonasal approach for anterior skull base tumors

Background: Although endoscopic endonasal approach (EEA) for skull base tumors showed a good prognosis in sinonasal quality of life (QOL), what factors have influence on QOL is still in question.Aim/Objectives: To investigate the recovery of sinonasal QOL after EEA for anterior skull base tumors and find its prognostic factors.Material and Methods: The study enrolled 250 patients undergoing EEA for anterior skull base tumors over 3 years. Sinonasal QOL was evaluated via sinonasal outcome test (SNOT-22) during 6 months. Age, gender, previous surgery, surgical extent, tumor pathology, combined surgical procedures, and surgical complications were analyzed.Results: There were 101 male and 149 female with average 48.616.1 years old. SNOT-22 increased from baseline (median 17.0; Q(1)-Q(3) 8.25-30.0) to postoperative 1 and 3 months (27.0; 15.0-36.0; p<.001 and 20.5; 11.0-32.0; p=.021, respectively) and it returned to the baseline within 6 months. Reconstruction with calcium hydroxyapatite and postoperative mucosal edema had a negative impact on the recovery (p =.016 and .010, respectively), after adjustment for the baseline scores and postoperative months.Conclusions and Significance: Sinonasal QOL was recovered within 6 months. Avoidance of calcium hydroxyapatite could prevent delayed recovery. Surgeons should carefully manipulate nasal mucosa to minimize postoperative mucosal edema.