J Neurol Surg B Skull Base 2016; 77 - FP-16-04
DOI: 10.1055/s-0036-1592521

Anxiety and Depression in Skull Base Surgery: A Comparison between Endonasal and Open Transcranial Approaches

Ehab Shiban 1, Youssef Shiban 2, Florian Bruckbauer 1, Jeff Thiel 1, Bernhard Meyer 1, Jens Lehmberg 1
  • 1Department of Neurosurgery, Technical University of Munich, Munich, Germany
  • 2Department of Experimental Psychology (Clinical Psychology and Psychotherapy), University of Regensburg, Regensburg, Germany

Objective: To evaluate the influence of the surgical approach (open versus endonasal) on the development of affective disorders and changes in quality of life following skull base surgery.

Methods: A prospective study of patients undergoing elective skull base surgery was performed. Evaluation for depression (ADS-K score) and anxiety (STAI - S, STAI -T and ASI- 3 score) were done before and three months after surgery. In addition SF-36 physical composite score (PCS) was completed before surgery and three month postoperatively.

Results: There were 9 (50%) patients in the endonasal and 9 (50%) patients in the open transcranial group. In the endonasal group abnormal STAI-S, STAI-T and ADS-K scores were encountered in 77.8, 44.4, and 33.3% of cases and in 66.7, 44.4, and 55.6% of cases in the open transcranial group before surgery, respectively. These differences were statistically significant (p = 0.001). At 3 months follow-up, abnormal STAI-S, STAI-T, and ADS-K scores were encountered in 55.6, 33.3, and 10% and in the endonasal group and in 50, 33.3, and 33.3% in the craniotomy group, respectively. These differences were also statistically significant (p = 0.001). However, there were no differences in quality of life before surgery and at three months follow-up between both groups.

Conclusion: In skull base surgery, the endonasal approach is associated with lower rates of affective disorders than with open craniotomy.