Predictors of improvement in quality of life at 12-month follow-up in patients undergoing anterior endoscopic skull base surgery

Buchlak, Quinlan D.; Esmaili, Nazanin; Bennett, Christine; Wang, Yi Yuen; King, James; Goldschlager, Tony

doi:10.1371/journal.pone.0272147

Cited by 6 publications

(6 citation statements)

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“…Therefore, the two aims of the currently study are distinct, yet complementary, and add value in different ways. From previous work, it is known that factors identified as significant using logistic regression align well with machine‐learning feature importance analysis 52,53 …”

Section: Discussionmentioning

confidence: 70%

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Predicting Acoustic Hearing Preservation Following Cochlear Implant Surgery Using Machine Learning

et al. 2023

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ObjectivesThe aim of the study was to train and test supervised machine‐learning classifiers to predict acoustic hearing preservation after CI using preoperative clinical data.Study DesignRetrospective predictive modeling study of prospectively collected single‐institution CI dataset.MethodsOne hundred and seventy‐five patients from a REDCap database including 761 patients >18 years who underwent CI and had audiometric testing preoperatively and one month after surgery were included. The primary outcome variable was the lowest quartile change in acoustic hearing at one month after CI using various formulae (standard pure tone average, SPTA; low‐frequency PTA, LFPTA). Analysis involved applying multivariate logistic regression to detect statistical associations and training and testing supervised learning classifiers. Classifier performance was assessed with numerous metrics including area under the receiver operating characteristic curve (AUC) and Matthews correlation coefficient (MCC).ResultsLowest quartile change (indicating hearing preservation) in SPTA was positively associated with a history of meningitis, preoperative LFPTA, and preoperative SPTA. Lowest quartile change in SPTA was negatively associated with sudden hearing loss, noise exposure, aural fullness, and abnormal anatomy. Lowest quartile change in LFPTA was positively associated with preoperative LFPTA. Lowest quartile change in LFPTA was negatively associated with tobacco use. Random forest demonstrated the highest mean classification performance on the validation dataset when predicting each of the outcome variables.ConclusionsMachine learning demonstrated utility for predicting preservation of residual acoustic hearing in patients undergoing CI surgery, and the detected associations facilitated the interpretation of our machine‐learning models. The models and statistical associations together may be used to facilitate improvements in shared clinical decision‐making and patient outcomes.Level of Evidence3 Laryngoscope, 2023

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Section: Discussionmentioning

confidence: 70%

“…From previous work, it is known that factors identified as significant using logistic regression align well with machine-learning feature importance analysis. 52,53 There are several formulae to calculate PTA. Conventional four-frequency PTA (SPTA) is most commonly used.…”

Section: Discussionmentioning

confidence: 99%

Predicting Acoustic Hearing Preservation Following Cochlear Implant Surgery Using Machine Learning

et al. 2023

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“…Two recent studies also identified gender differences in QoL after skull base surgery. 9,10 The first study by Buchlak et al in 2022 found that low preoperative QoL is negatively associated with female gender in endoscopic pituitary surgery using the anterior skull base surgery (ASBS) questionnaire. Another study by Fleseriu et al in 2023 also found worse baseline rhinologic QoL in female patients using the SNOT-22 rhinologic domain in patients with sinonasal malignancy.…”

Section: Discussionmentioning

confidence: 99%

Gender Differences in Quality-of-Life Outcome in Patients Undergoing Endoscopic Endonasal Skull Base Surgery

Tumlin,

Al-Asadi,

Turner

et al. 2023

J Neurol Surg B Skull Base

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Background Prior studies showed that female patients with chronic rhinosinusitis (CRS) suffer a worse disease-specific quality of life (QoL). Goal The aim of this study is to investigate gender differences in sinonasal QoL outcomes in patients requiring endoscopic endonasal skull base surgeries (EESBS). Methods Cross-sectional analysis of patients presenting to our clinic from August 2020 to December 2022 with skull base tumors, spontaneous cerebrospinal fluid (CSF) rhinorrhea, or Grave's orbitopathy (for orbital decompression) was performed. Baseline and postsurgical QoL were measured using the 22-item Sinonasal Outcome Test (SNOT-22). Patients' demographics and comorbidities were reviewed. Patients with concomitant CRS were excluded. Results Eighty-six patients were included (54 with skull base tumors, 17 Grave's orbitopathy, and 15 spontaneous CSF rhinorrhea). The mean age of the patients was 52 years (range: 12.4–81.5 years), and 51.6% of the patients were females. There was no age difference between female and male patients. Smoking history, asthma, and allergic rhinitis were also similar between the two groups. Female patients had a significantly higher incidence of depression (58.3 vs. 32.4%, p = 0.018) and migraine (50.0 vs. 21.6%, p = 0.007). Female patients had a significantly worse overall SNOT-22 scores at baseline (33.6 vs. 18.2, p = 0.001), at the 3-month follow-up (29.7 vs. 15.5, p = 0.002), and at the 6-month follow-up (33.5 vs. 14.9, p = 0.005). This worse QoL was seen mainly in the ear/facial, sleep, and psychological domains. Linear regression of the SNOT-22 scores and its subdomains adjusting for comorbidities showed that migraine was found to be the most significant determinant of gender differences in the QoL. Conclusion Female patients who undergo EESBS show higher overall SNOT-22 scores secondary to higher incidence of migraine.

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“…However, low preoperative QoL was significantly associated with female sex and diabetes in a prospective cohort with pituitary lesions. 15 Therefore, comorbidities appeared to have a general effect on the preoperative QoL of patients undergoing anterior skull base surgery. Worse postoperative QoL was significantly correlated with tumor necrosis, larger coronal maximum diameter, and postoperative adjuvant therapy in univariate analysis.…”

Section: Discussionmentioning

confidence: 99%

“…At present, numerous studies have explored the changes in QoL after EES for benign diseases of the anterior skull base, 11 , 15 , 16 but for malignant tumors of the anterior skull base, the literature is limited and heterogeneous. In a prospective study involving 66 sinonasal malignant patients undergoing endoscopic skull base surgery, Glicksman et al found that sinonasal QoL, as measured by the SNOT-22, appeared to significantly improve at 3 months following resection when compared with the preoperative baseline, and this improvement was sustained throughout a 2-years follow-up.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Endoscopic Endonasal Surgery on Quality of Life in Patients with Malignant Tumors of the Anterior Skull Base: A Prospective Study

Fan¹,

Li²,

Zhang³

et al. 2023

CMAR

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Objective To investigate the effects of endoscopic endonasal surgery (EES) on longitudinal quality of life (QoL) in patients with malignant tumors of the anterior skull base. Methods Eligible patients prospectively completed the Anterior Skull Base Surgery Questionnaire (ASBQ) and the 22-item Sino-Nasal Outcome Test (SNOT-22) questionnaires in referring to 3 different periods throughout their treatment and recovery. Results Forty patients were included. The median volume coronal maximum length of the tumor was 3.6 cm (95% CI 2.7–4.1cm). Overall QoL significantly worsened at 1 month postoperatively but returned to baseline after 1 year. Unrelieved symptoms in specific domains prompted further evaluation of individual items. Transient worsening of taste (p=0.011) and olfaction (p=0.004) lasted for 1 month but gradually relieved within the first postoperative year, but vision consistently worsened over the course of the treatment (p=0.126). Age>50 years (p<0.001), comorbidities (p<0.001), tumor necrosis (p<0.001) and recurrence (p=0.001) were associated with worse preoperative QoL. Poor long-term QoL was noted in those undergoing adjuvant therapy (p=0.032). Overall ASBQ scores (p=0.024), subdomain scores in specific symptoms (p=0.016), and vision scores (p=0.009) were worse only in patients with the greater coronal maximum diameter at 1-month postoperatively. Greater coronal maximum diameter was related to worse preoperative subdomain scores regarding specific symptoms (p=0.030) and decreased postoperative long-term decreased vision scores (p=0.014). Conclusion Long-term site-specific and sinonasal QoL eventually stabilized after EES. Greater coronal maximum diameter was significantly associated with worsened vision function. Temporarily worse olfactory, vision, and taste function may be tied to decreased short-term QoL.

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Predictors of improvement in quality of life at 12-month follow-up in patients undergoing anterior endoscopic skull base surgery

Cited by 6 publications

References 71 publications

Predicting Acoustic Hearing Preservation Following Cochlear Implant Surgery Using Machine Learning

Predicting Acoustic Hearing Preservation Following Cochlear Implant Surgery Using Machine Learning

Gender Differences in Quality-of-Life Outcome in Patients Undergoing Endoscopic Endonasal Skull Base Surgery

The Impact of Endoscopic Endonasal Surgery on Quality of Life in Patients with Malignant Tumors of the Anterior Skull Base: A Prospective Study

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