Background Prior studies showed that female patients with chronic rhinosinusitis (CRS) suffer a worse disease-specific quality of life (QoL).

Goal The aim of this study is to investigate gender differences in sinonasal QoL outcomes in patients requiring endoscopic endonasal skull base surgeries (EESBS).

Methods Cross-sectional analysis of patients presenting to our clinic from August 2020 to December 2022 with skull base tumors, spontaneous cerebrospinal fluid (CSF) rhinorrhea, or Grave's orbitopathy (for orbital decompression) was performed. Baseline and postsurgical QoL were measured using the 22-item Sinonasal Outcome Test (SNOT-22). Patients' demographics and comorbidities were reviewed. Patients with concomitant CRS were excluded.

Results Eighty-six patients were included (54 with skull base tumors, 17 Grave's orbitopathy, and 15 spontaneous CSF rhinorrhea). The mean age of the patients was 52 years (range: 12.4–81.5 years), and 51.6% of the patients were females. There was no age difference between female and male patients. Smoking history, asthma, and allergic rhinitis were also similar between the two groups. Female patients had a significantly higher incidence of depression (58.3 vs. 32.4%, p = 0.018) and migraine (50.0 vs. 21.6%, p = 0.007). Female patients had a significantly worse overall SNOT-22 scores at baseline (33.6 vs. 18.2, p = 0.001), at the 3-month follow-up (29.7 vs. 15.5, p = 0.002), and at the 6-month follow-up (33.5 vs. 14.9, p = 0.005). This worse QoL was seen mainly in the ear/facial, sleep, and psychological domains. Linear regression of the SNOT-22 scores and its subdomains adjusting for comorbidities showed that migraine was found to be the most significant determinant of gender differences in the QoL.

Conclusion Female patients who undergo EESBS show higher overall SNOT-22 scores secondary to higher incidence of migraine.

背景 先前的研究表明，患有慢性鼻窦炎 (CRS) 的女性患者的疾病特异性生活质量 (QoL) 较差。

目标 本研究的目的是调查需要内镜鼻内颅底手术 (EESBS) 的患者鼻鼻腔生活质量结果的性别差异。

方法 对 2020 年 8 月至 2022 年 12 月就诊的患有颅底肿瘤、自发性脑脊液 (CSF) 鼻漏或格雷夫氏眼眶病（用于眼眶减压）的患者进行横断面分析。使用 22 项鼻鼻结果测试 (SNOT-22) 测量基线和术后生活质量。对患者的人口统计数据和合并症进行了审查。排除伴有 CRS 的患者。

结果 纳入 86 例患者（54 例患有颅底肿瘤，17 例格雷夫氏眼眶病，15 例自发性脑脊液鼻漏）。患者的平均年龄为52岁（范围：12.4-81.5岁），其中51.6%的患者为女性。女性和男性患者之间没有年龄差异。两组之间的吸烟史、哮喘和过敏性鼻炎也相似。女性患者抑郁症（58.3% vs. 32.4%， p  = 0.018）和偏头痛（50.0% vs. 21.6%，p = 0.007）的发生率显着较高 。女性患者在基线时（33.6 vs. 18.2， p  = 0.001）、3 个月随访时（29.7 vs. 15.5，p  = 0.002）和 6 个月随访时的总体 SNOT-22 评分显着较差上升（33.5 与 14.9，p  = 0.005）。这种较差的生活质量主要体现在耳朵/面部、睡眠和心理领域。SNOT-22 评分及其针对合并症调整的子域的线性回归表明，偏头痛被发现是生活质量性别差异的最显着决定因素。

结论 接受 EESBS 的女性患者因偏头痛发生率较高而表现出较高的 SNOT-22 总体评分。