Stakeholder Analysis Identifies Key Patient Priorities for Endoscopic Sellar/Parasellar and Anterior Skull Base Resections

Background: Patients are critical stakeholders who offer firsthand experience with their healthcare; however, patient perspectives on health and research priorities in skull base surgery are not well-elucidated. Existing quality-of-life (QOL) measures in skull base surgery are heterogeneous and correlate inconsistently with surgical outcomes. This study aimed to obtain feedback from patients who underwent endoscopic skull base tumor resections to inform the development of patient-centered tools, policies, and research. Methods: Patients were prospectively enrolled from three academic medical centers and categorized as sellar/parasellar or anterior skull base (ASB) patients. Demographic information, barriers to study participation, and perceived surgical efficacy were collected. The Skull Base Inventory (SBI), SNOT-22, and Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS) were adapted to assess patients’ health and research priorities using a Likert scale of 0 [not relevant] to 5 [very important]. Results: Thirty-four patients in the sellar/parasellar cohort and 28 in the ASB cohort completed the questionnaires postoperatively. Higher Likert scores indicated greater patient priority. The sellar/parasellar group prioritized visual symptoms (2.7/5), energy level (3.1/5), and the need to blow nose (2.6/5). The ASB group prioritized nasal breathing (3.1/5) and smell and taste dysfunction (3.2/5). Patients were interested in research exploring the side effects of skull base surgery but expressed concern for respondent fatigue. Conclusion: Stakeholder feedback indicated patients undergoing sellar/parasellar resections prioritize symptoms related to vision and fatigue, while patients undergoing ASB prioritize olfaction and nasal breathing. These findings should be incorporated into the design of future investigations and patient counseling.