Databases for Skull Bases

Advances in endoscopic cranial base surgery have fostered collaborations between specialties such as neurosurgery, otolaryngology, and ophthalmology. It is necessary to merge data from these departments in order to track patient outcomes, to comply with pay-for-performance programs, and to confirm treatment efficacy. Using off-the-shelf software, we developed a customized database that can be adapted to manage data for any cranial base program. Drop-down menus allow consistent, searchable data entry, and the menus can be expanded as necessary. Our database captures demographics, presentation, and comorbidities; diagnoses; dates, types, and results of imaging and clinicians' notes; surgical details including approach used, completeness of resection, blood loss, and skull base repair; and links to images stored on a server. Start-up costs were modest (the price of the software). Once surgeons and administration agreed on which fields to track and what data values could be allowed, the implementation was easy. With the rapid growth of extended endonasal cranial base procedures and programs, it is essential that objective comparisons be made with more conventional treatments. Collecting data in real time allows for easy mining of data to evaluate outcomes objectively and quickly. It also can be used to see early trends as they develop.