Prospective Study of Sinonasal Outcome Following Endoscopic Skull Base Surgery

Background: Endoscopic endonasal surgery (EES) requires wide sinonasal dissection to achieve adequate visualisation of anatomical landmarks. This can also result in nasal sequelae like crusting, nasal discharge, and anosmia. Aim: To use the sinonasal outcome test (SNOT) 22 questionnaire to study the postoperative sinonasal morbidity and its recovery in patients who have undergone EES. Materials and Method: Prospective study conducted from November 2017 to May 2018. SNOT-22 questionnaire was administered on patients operated between before EES and then re-administered during outpatient visits at 1 month, 3 months, and 6-12 months following surgery. Results: Results of 46 patients were analyzed. The mean duration of follow-up was 11.8 months. The mean preoperative SNOT-22 score was 2.69 +/- 4.95. SNOT-22 score at 1 month was 5.52 +/- 6.77, at 3 months follow-up was 0.39 +/- 1.02, and after 6 months was 0.30 +/- 1.00. In 32 patients with a nasoseptal flap, mean preoperative score was 3.34 +/- 5.68 (P = 0.18), one month following surgery it was 6.68 +/- 6.88 and at 3 and 6 months following surgery it was 0.56 +/- 1.19 and 0.38 +/- 1.15. The mean preoperative nasal domain score was 1.022 (+/- 2.13), the postoperative 1 month score was 2.3 +/- 3.7, at 3 months following surgery was 0.22 +/- 0.82 and after 6 months of surgery was 0.28 +/- 0.96. Conclusion: Patients undergoing EES experienced transient worsening of SNOT 22 scores in the first month following surgery and recovered within 3 months of surgery. The improvement was sustained in follow-up visits beyond 6 months of surgery.