Quality of Life After Combined Endonasal Endoscopic Odontoidectomy and Posterior Suboccipital Decompression and Fusion

Malte Ottenhausen, Andrew F. Alalade, Kavelin Rumalla, Prakash Nair, Mhd-Ali - Baaj, Roger Hartl, Ashutosh Kacker, Jeffrey P. Greenfield, Vijay K. Anand, Theodore H. Schwartz

Research output: Contribution to journalArticle

Abstract

Background: Basilar invagination can result from systemic diseases that can weaken structural integrity of the craniocervical junction. Definitive treatment often requires ventral decompression and posterior decompression and fusion. Endonasal odontoidectomy is a relatively new minimal access procedure; quality of life (QOL) after this procedure has not been reported. Methods: We reviewed a consecutive database of endonasal odontoidectomy cases and identified patients having posterior decompression and fusion. Two QOL questionnaires were administered postoperatively: Sino-Nasal Outcome Test and 36-Item Short Form Survey. Comparisons with other endonasal or Chiari procedures were performed. Results: The study comprised 14 patients; 79% had Chiari malformation in addition to basilar invagination. Mean follow-up was 17.2 months. Symptomatic improvement occurred in 78.6% after surgery. Average postoperative Sino-Nasal Outcome Test scores were 39.2 ± 17.93, with worst scores in areas related to fatigue and sleep patterns but not nasal function. 36-Item Short Form Survey scores were lower in areas of physical function and general health but better for emotional health and pain. Compared with patients undergoing Chiari malformation surgery without endonasal odontoid resection or fusion, patients undergoing odontoidectomy had higher QOL in areas of role emotional, emotional well-being, and pain but worse QOL in general health and role physical. Conclusions: Patients undergoing posterior decompression and fusion with endonasal odontoidectomy do well after surgery with respect to nasal function and emotional health. Patients who also have severe basilar invagination associated with systemic diseases demonstrate reduced QOL after surgery in areas of physical function and sleep leading to fatigue, irritability, and concentration difficulty, likely related to their systemic disease.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

Fingerprint

Decompression
Quality of Life
Nose
Health
Fatigue
Sleep
Pain
Databases
Surveys and Questionnaires

Keywords

  • Basilar invagination
  • Chiari
  • Endonasal
  • Endoscopic
  • Minimal access
  • Minimally invasive
  • Odontoid
  • Transnasal

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Quality of Life After Combined Endonasal Endoscopic Odontoidectomy and Posterior Suboccipital Decompression and Fusion. / Ottenhausen, Malte; Alalade, Andrew F.; Rumalla, Kavelin; Nair, Prakash; Baaj, Mhd-Ali -; Hartl, Roger; Kacker, Ashutosh; Greenfield, Jeffrey P.; Anand, Vijay K.; Schwartz, Theodore H.

In: World Neurosurgery, 01.01.2018.

Research output: Contribution to journalArticle

Ottenhausen, Malte ; Alalade, Andrew F. ; Rumalla, Kavelin ; Nair, Prakash ; Baaj, Mhd-Ali - ; Hartl, Roger ; Kacker, Ashutosh ; Greenfield, Jeffrey P. ; Anand, Vijay K. ; Schwartz, Theodore H. / Quality of Life After Combined Endonasal Endoscopic Odontoidectomy and Posterior Suboccipital Decompression and Fusion. In: World Neurosurgery. 2018.
@article{386d242cf3cf40b89bffe51bf099863a,
title = "Quality of Life After Combined Endonasal Endoscopic Odontoidectomy and Posterior Suboccipital Decompression and Fusion",
abstract = "Background: Basilar invagination can result from systemic diseases that can weaken structural integrity of the craniocervical junction. Definitive treatment often requires ventral decompression and posterior decompression and fusion. Endonasal odontoidectomy is a relatively new minimal access procedure; quality of life (QOL) after this procedure has not been reported. Methods: We reviewed a consecutive database of endonasal odontoidectomy cases and identified patients having posterior decompression and fusion. Two QOL questionnaires were administered postoperatively: Sino-Nasal Outcome Test and 36-Item Short Form Survey. Comparisons with other endonasal or Chiari procedures were performed. Results: The study comprised 14 patients; 79{\%} had Chiari malformation in addition to basilar invagination. Mean follow-up was 17.2 months. Symptomatic improvement occurred in 78.6{\%} after surgery. Average postoperative Sino-Nasal Outcome Test scores were 39.2 ± 17.93, with worst scores in areas related to fatigue and sleep patterns but not nasal function. 36-Item Short Form Survey scores were lower in areas of physical function and general health but better for emotional health and pain. Compared with patients undergoing Chiari malformation surgery without endonasal odontoid resection or fusion, patients undergoing odontoidectomy had higher QOL in areas of role emotional, emotional well-being, and pain but worse QOL in general health and role physical. Conclusions: Patients undergoing posterior decompression and fusion with endonasal odontoidectomy do well after surgery with respect to nasal function and emotional health. Patients who also have severe basilar invagination associated with systemic diseases demonstrate reduced QOL after surgery in areas of physical function and sleep leading to fatigue, irritability, and concentration difficulty, likely related to their systemic disease.",
keywords = "Basilar invagination, Chiari, Endonasal, Endoscopic, Minimal access, Minimally invasive, Odontoid, Transnasal",
author = "Malte Ottenhausen and Alalade, {Andrew F.} and Kavelin Rumalla and Prakash Nair and Baaj, {Mhd-Ali -} and Roger Hartl and Ashutosh Kacker and Greenfield, {Jeffrey P.} and Anand, {Vijay K.} and Schwartz, {Theodore H.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.wneu.2018.05.041",
language = "English (US)",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Quality of Life After Combined Endonasal Endoscopic Odontoidectomy and Posterior Suboccipital Decompression and Fusion

AU - Ottenhausen, Malte

AU - Alalade, Andrew F.

AU - Rumalla, Kavelin

AU - Nair, Prakash

AU - Baaj, Mhd-Ali -

AU - Hartl, Roger

AU - Kacker, Ashutosh

AU - Greenfield, Jeffrey P.

AU - Anand, Vijay K.

AU - Schwartz, Theodore H.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Basilar invagination can result from systemic diseases that can weaken structural integrity of the craniocervical junction. Definitive treatment often requires ventral decompression and posterior decompression and fusion. Endonasal odontoidectomy is a relatively new minimal access procedure; quality of life (QOL) after this procedure has not been reported. Methods: We reviewed a consecutive database of endonasal odontoidectomy cases and identified patients having posterior decompression and fusion. Two QOL questionnaires were administered postoperatively: Sino-Nasal Outcome Test and 36-Item Short Form Survey. Comparisons with other endonasal or Chiari procedures were performed. Results: The study comprised 14 patients; 79% had Chiari malformation in addition to basilar invagination. Mean follow-up was 17.2 months. Symptomatic improvement occurred in 78.6% after surgery. Average postoperative Sino-Nasal Outcome Test scores were 39.2 ± 17.93, with worst scores in areas related to fatigue and sleep patterns but not nasal function. 36-Item Short Form Survey scores were lower in areas of physical function and general health but better for emotional health and pain. Compared with patients undergoing Chiari malformation surgery without endonasal odontoid resection or fusion, patients undergoing odontoidectomy had higher QOL in areas of role emotional, emotional well-being, and pain but worse QOL in general health and role physical. Conclusions: Patients undergoing posterior decompression and fusion with endonasal odontoidectomy do well after surgery with respect to nasal function and emotional health. Patients who also have severe basilar invagination associated with systemic diseases demonstrate reduced QOL after surgery in areas of physical function and sleep leading to fatigue, irritability, and concentration difficulty, likely related to their systemic disease.

AB - Background: Basilar invagination can result from systemic diseases that can weaken structural integrity of the craniocervical junction. Definitive treatment often requires ventral decompression and posterior decompression and fusion. Endonasal odontoidectomy is a relatively new minimal access procedure; quality of life (QOL) after this procedure has not been reported. Methods: We reviewed a consecutive database of endonasal odontoidectomy cases and identified patients having posterior decompression and fusion. Two QOL questionnaires were administered postoperatively: Sino-Nasal Outcome Test and 36-Item Short Form Survey. Comparisons with other endonasal or Chiari procedures were performed. Results: The study comprised 14 patients; 79% had Chiari malformation in addition to basilar invagination. Mean follow-up was 17.2 months. Symptomatic improvement occurred in 78.6% after surgery. Average postoperative Sino-Nasal Outcome Test scores were 39.2 ± 17.93, with worst scores in areas related to fatigue and sleep patterns but not nasal function. 36-Item Short Form Survey scores were lower in areas of physical function and general health but better for emotional health and pain. Compared with patients undergoing Chiari malformation surgery without endonasal odontoid resection or fusion, patients undergoing odontoidectomy had higher QOL in areas of role emotional, emotional well-being, and pain but worse QOL in general health and role physical. Conclusions: Patients undergoing posterior decompression and fusion with endonasal odontoidectomy do well after surgery with respect to nasal function and emotional health. Patients who also have severe basilar invagination associated with systemic diseases demonstrate reduced QOL after surgery in areas of physical function and sleep leading to fatigue, irritability, and concentration difficulty, likely related to their systemic disease.

KW - Basilar invagination

KW - Chiari

KW - Endonasal

KW - Endoscopic

KW - Minimal access

KW - Minimally invasive

KW - Odontoid

KW - Transnasal

UR - http://www.scopus.com/inward/record.url?scp=85048242665&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048242665&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2018.05.041

DO - 10.1016/j.wneu.2018.05.041

M3 - Article

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -