J Neurol Surg B Skull Base 2015; 76 - P046
DOI: 10.1055/s-0035-1546674

Preliminary Results of the Skull Base Inventory: A Quality-of-Life Instrument for Skull Base Pathologies

Soroush Larjani 1, Eric Monteiro 1, Allan Vescan 2, Gelareh Zadeh 3, Fred Gentili 3, John R. de Almeida 1
  • 1Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
  • 2Mount Sinai Hospital, New York, United States
  • 3Toronto Western Hospital, University Health Network, Toronto, Canada

Background: Skull base tumors pose difficult challenges for resection with consequent impact on quality of life. We developed a new comprehensive skull base quality of life questionnaire, the skull base inventory (SBI), with face and content validity. Herein, we explore its psychometric properties in a prospective cohort study of patients undergoing endoscopic skull base surgery.

Methods: A prospective cohort study of patients undergoing endoscopic skull base surgery at Toronto Western Hospital between March 2011 and July 2014 was conducted. Patients were administered a set of three questionnaires, anterior skull base (ASB), Sino-Nasal Outcome Test-22 (SNOT-22), and SBI, both preoperatively, and postoperatively at 1, 3, 6, and 12 months. Reliability of the SBI was assessed using internal consistency (Cronbach α). Concurrent validity was tested by comparing global scores of SBI with ASB, and by comparing scores from the nasal domain of SBI with scores from SNOT-22 using Pearson correlation coefficient. Validity was further assessed by comparing SBI global score with patients' self-reported overall quality of life, and by comparing the SBI nasal domain score with patients' self-reported change in nasal function after surgery, using ANOVA. All statistical analyses were performed using IBM SPSS 20.0.

Results: A total of 39 patients completed a total of 61 sets of questionnaires at various time points. Reliability for each domain of SBI ranged from acceptable to excellent (α = 0.63–0.92), and the overall reliability was excellent (α = 0.94). Concurrent validity of SBI and ASB was good with a Pearson correlation coefficient of 0.775. Scores from the nasal domain of the SBI also correlated well with the overall scores of SNOT-22 (r = 0.63). SBI global scores differed significantly between different levels of quality of life reported by patients (p < 0.001). SBI nasal domain scores, however, did not show a significant difference between different levels of nasal function after surgery (p = 0.097). SBI and ASB scores showed a temporary decline in overall quality of life after surgery, but they were followed by recovery at 9 to 18 months.

Conclusion: Preliminary results demonstrate that the SBI has strong psychometric properties, and is both reliable and valid in predicting patient's quality of life after endoscopic skull base surgery.