Site-Specific Quality of Life Outcomes Following Anterior Skull Base Surgery: A Systematic Review and Meta-Analysis

Paige Shipman; Erica Arnold; Daniel M Beswick; Nicholas R Rowan; Michael Karsy; Jeremiah A Alt; Amarbir S Gill

doi:10.1016/j.wneu.2024.02.129

Site-Specific Quality of Life Outcomes Following Anterior Skull Base Surgery: A Systematic Review and Meta-Analysis

World Neurosurg. 2024 Feb 29:185:254-260. doi: 10.1016/j.wneu.2024.02.129. Online ahead of print.

Authors

Paige Shipman¹, Erica Arnold¹, Daniel M Beswick², Nicholas R Rowan³, Michael Karsy⁴, Jeremiah A Alt¹, Amarbir S Gill⁵

Affiliations

¹ Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA.
² Department of Otolaryngology - Head and Neck Surgery, University of California, Los Angeles, California, USA.
³ Department of Otolaryngology - Head and Neck Surgery, John Hopkins University, Baltimore, Maryland, USA.
⁴ Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA.
⁵ Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA. Electronic address: asingill@med.umich.edu.

PMID: 38431213
DOI: 10.1016/j.wneu.2024.02.129

Abstract

Background: There is a limited understanding of site-specific, quality of life (QOL) outcomes in anterior skull base surgery (ASBS). The objective of the present investigation was to characterize postoperative change in QOL outcomes for anterior skull base lesions following open and endoscopic surgery.

Methods: A comprehensive review of the literature was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using the PubMed, Scopus, Embase, and Cochrane databases for studies reporting pre- and postoperative, site-specific, QOL outcome measures in ASBS using validated questionnaires. Studies utilizing the anterior skull base quality of life (ASBQ) questionnaire or the skull base inventory were included. Investigations focusing on skull base surgery for pituitary lesions, as well as survey validation and non-English studies, were excluded.

Results: A total of 112 studies were screened; 4 studies, comprising a total of 195 patients and focusing exclusively on the ASBQ, were included in the systematic review. Using a fixed effect model for the meta-analysis, the mean ASBQ score was similar at six (3.45, P = 0.312; -0.19, 95% confidence interval: -0.57, 0.18) and 12 months postoperatively (3.6, P = 0.147; 0.3, 95% confidence interval: -0.11, 0.72) compared to baseline (3.53).

Conclusions: Across a variety of anterior skull base pathologies, skull base-specific QOL demonstrated no improvement at 6 months and 12 months postsurgery. Few studies to date have published pre- and postoperative QOL data for patients undergoing ASBS, highlighting a current shortcoming in the available literature. Long-term follow-up in patients undergoing open and endoscopic approaches will be necessary to better understand and optimize outcomes for patients having ASBS.

Keywords: Anterior skull base quality of life questionnaire; Patient reported outcome measures; Quality of life; Skull base inventory; Skull base surgery.

Publication types

Review