Postoperative mometasone irrigations improve quality of life in skull base tumor patients

• Published in: World journal of otorhinolaryngology - head and neck surgery Vol. 9; no. 4; pp. 314 - 319
• Main Authors: Salmon, Mandy K., Kshirsagar, Rijul S., Eide, Jacob G., Sweis, Auddie M., Davin, Kathleen, Prasad, Aman, Ungerer, Heather, Stevens, Elizabeth, Ig‐Izevbekhai, Kevin, Tripathi, Siddhant, Locke, Tran B., Lin, Theodore, Sweis, Brian M., Kohanski, Michael A., Adappa, Nithin D., Palmer, James N.
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.12.2023; John Wiley and Sons Inc; Wiley
• Subjects: Brain cancer; Cysts; Endoscopy; Females; Inflammatory diseases; Patients; Postoperative period; postoperative steroid irrigations; Quality of life; Radiation therapy; Research Paper; Research Papers; skull base tumors; Steroids; Surgery; Tumors; skull base tumors; postoperative steroid irrigations
• ISSN: 2095-8811; 2589-1081; 2589-1081
• DOI: 10.1002/wjo2.99

Objectives The use of topical corticosteroids to manage postoperative sinonasal symptoms after endoscopic skull base surgery (ESBS) has not been well studied. We quantified long‐term impact of postoperative steroid irrigations (SIs) on quality of life of patients after ESBS. Methods Retrospective review of patients at the University of Pennsylvania undergoing ESBS from 2010 to 2019. Data on patient demographics and postoperative treatment with nasal saline irrigation twice daily with and without dissolved steroids (mometasone or budesonide) was collected. Preoperative, and 1‐, 3‐, 6‐, 12‐, 18‐, and 24‐month postoperative Sino‐Nasal Outcome Test (SNOT‐22) scores were assessed. Results A total of 727 patients were assessed (53.4% males), with 479 patients in the no SI group and 248 patients in the SI group. Preoperative SNOT‐22 scores did not differ significantly (P = 0.19). 1‐, 3‐, 6‐, 12‐, 18‐, and 24‐month post‐op SNOT‐22 scores did not significantly differ between groups. However, mometasone irrigations resulted in significantly lower postoperative 2‐year SNOT‐22 scores compared to budesonide (P < 0.01) and saline (P = 0.03). Conclusions Though corticosteroid irrigations are routine in managing inflammatory sinus disease, their role in postoperative management after ESBS for tumors is unclear. Our findings suggest that mometasone irrigation may be effective at improving postoperative quality of life in patients after ESBS.