Abstract
Introduction:
The nasal cavity is becoming more commonly exploited as a corridor to address anterior skull base lesions, but little emphasis has been placed on rhinological outcomes and quality of life. The goal of this project was to develop a simple, prospectively validated, site-specific quality-of-life instrument specifically for assessing nasal outcomes following endonasal skull base surgery. Preliminary results are presented.
Methods:
A 10-item patient survey (Anterior SKull base Nasal Inventory, or “ASK Nasal Inventory”) focusing on the most common postoperative complaints, such as crusting, sense of smell, sinusitis, pain, and ease of breathing, was developed by the anterior skull base team at the Barrow Neurological Institute. Content was validated in structured patient interviews and by four subject matter experts. This survey was self-administered before and 3 and 6 months after surgery to 94 patients (52 who underwent endonasal surgery and 42 controls) between October 2010 and August 2011. Standard methods for psychometric evaluation were applied to the ASK Nasal Inventory.
Results:
Cronbach's alpha was 0.83, indicating good internal consistency. Test-retest reliability using a Pearson correlation was 0.91 (
P
< 0.001), indicating good reliability. Discriminant validity was evaluated by comparing mean scores at 3 months in the endonasal group with the control group (13.5 vs. 17.2,
P
= 0.001), thus confirming expected changes in nasal functioning in the endonasal surgery patients. Standardized response mean was 0.17, suggesting that the scale was sensitive to clinical change. Concurrent validity was determined by mean ASK Nasal score for each level of self-reported overall functioning using ANOVA. We noted the expected differences in the mean ASK Nasal Inventory scores for different overall levels of nasal functioning (
P
= 0.001).
Conclusions:
Preliminary evaluation of the performance of the ASK Nasal Inventory quality-of-life tool suggests that it meets basic psychometric criteria and has potential as a clinical and research instrument in anterior skull base surgery. Final validation awaits the completion of an ongoing multicenter rhinological outcomes study.