2025 Proffered Presentations
S360: QUALITY OF LIFE AND ITS ASSESSMENT IN PATIENTS WITH SPHENOORBITAL MENINGIOMAS
Nikolay Lasunin; Anna Kadasheva; Abdulla Abdullaev; Yulia Strunina; Burdenko Neurosurgical Center
Introduction: Hyperostotic sphenoorbital meningiomas (HSOM) are a type of benign tumor associated with favorable long-term outcomes, featuring 10-year overall survival rates of 91% and recurrence-free rates of 44%. Surgical intervention aimed at maximal tumor resection can lead to substantial improvements in both functional and cosmetic aspects of quality of life (QoL); however, it does not always ensure optimal outcomes. Evaluating the quality of life in patients with this condition presents considerable challenges, and there is a notable scarcity of published literature addressing this issue.
Material: To assess QoL in patients with HSOM, we developed a specialized questionnaire that captures the patient's subjective evaluation of quality of life across several indicators: physical condition, emotional well-being, work and social interactions, vision, appearance, sensitivity, and pain. The survey included 216 participants, with an average time since surgical intervention (or the last surgery for those who underwent multiple procedures) of 30.7 months (approximately 2.5 years). The average age of the participants was 57.2 years, and the ratio of men to women in the surveyed group was 1:7.
Results: The objectification of subjective assessments of visual functions revealed that, despite a significant correlation between actual visual functions and their subjective evaluations in the study group (p<0.001), a substantial number of patients tend to overestimate or exaggerate the severity of their issues. A generally low quality of life is often associated with an excessively negative perception of visual functions, even in cases where there are no visual or oculomotor disturbances (Pic. 1).
Conversely, a high overall quality of life assessment may correlate with an unreasonably inflated perception of visual functions, even when pronounced visual and oculomotor deficits are present (Pic. 2).
Therefore, it is crucial for patients with HSOM to undergo a comprehensive evaluation of surgical outcomes related to visual functions, which should encompass both objective ophthalmological examinations and subjective quality of life assessments. Additionally, patients experiencing significant visual impairments and/or low quality of life should be referred to a psychiatrist or psychotherapist for the management of psycho-emotional issues.
The cosmetic outcome is the most complex aspect of quality of life to interpret. Notably, satisfaction with cosmetic results tends to be the highest among all factors influencing quality of life. However, efforts to objectify cosmetic assessments through expert evaluations suggest that physicians' and patients' opinions regarding surgical cosmetic outcomes often align in cases of distinctly positive or negative results. In instances of minor facial asymmetry, predicting how either the patient or another expert will interpret the surgical outcome becomes nearly impossible, as the likelihood of agreement approaches random chance (Pic. 3).
Conclusions: Patients with HSOM constitute a unique group for whom assessing quality of life is difficult without a specialized questionnaire. The questionnaire we developed addresses both general factors relevant to any neurosurgical patient and specific categories pertinent to craniofacial surgery that influence overall quality of life. Implementing this questionnaire and evaluating quality of life at all stages of treatment will facilitate a personalized approach and optimize treatment strategies for patients with HSOM.