Health-Related Quality of Life in Adult Patients with Craniopharyngioma.

OBJECTIVE: Craniopharyngiomas (CPs) are benign, dysontogenetic tumors associated with complex endocrinologic and neurologic symptoms and high morbidity. The aim of this study is to elucidate modifiable effectors of health-related quality of life (HrQoL) of adult patients with CP following neurosurgical intervention using standardized instruments as well as descriptive analysis. METHODS: HrQoL (European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire C30 and BN20) was evaluated in 20 adult patients with CP. We examined pre- as well as postoperative radiologic, hormonal, and symptom-oriented data in a retrospective analysis. Surgical approach, postoperative complications, and extent of resection were recorded. Additional descriptive analysis was performed on case records of all patients with HrQoL results. RESULTS: Long-term follow-up of HrQoL (mean of 75 months) was lower than the in healthy reference group (CP = 58, reference = 75). The most common postoperative complaints were endocrinologic disturbances (88%). Overall, univariate and multivariate logistic regression analysis revealed no significant predictors of reduced postoperative HrQoL. Descriptive analysis did, however, reveal a cluster of patients among those with the lowest global HrQoL which reported new postoperative anosmia and ageusia. CONCLUSIONS: The global HrQoL of our cohort showed a substantial reduction compared with a healthy reference population. Postoperative hyposmia and ageusia is found in patients with the lowest postoperative HrQoL who otherwise had no new significant endocrinologic or neurologic complications. As these symptoms are not regularly accounted for in the HrQoL instruments used in this study, further analysis is needed to determine the possible significance of this complication in CP surgery, and it may affect the choice of surgical approach as well as the information patients receive before consenting to surgery.

Sense of smell disorder and health-related quality of life.

OBJECTIVES: To compare health-related quality of life and depression between individuals with an inability to smell (anosmia) and a comparison group of individuals with a normal sense of smell. METHODS: Ninety individuals from an anosmia organization (anosmia based on self-report) were compared to 89 individuals with a normal sense of smell. The SF-36 and Beck Depression Inventory-II-NL (BDI-II-NL) were administered, along with the Questionnaire for Olfactory Dysfunction (QOD) to assess the degree of problems in daily life related to the smell impairment. RESULTS: Compared to the comparison group, scores in the anosmia group differed on: the QOD-subscale Life Quality (related to tasting and smelling: p < .001) and Parosmia (Smelling odors as different: p < .001); and the SF-36 subscales of Social Functioning, Vitality, Mental Health and General Health (p's < .05). Persons with anosmia scored higher on the BDI-II-NL than persons from the comparison group (p < .01). DISCUSSION: Once a smell dysfunction is recognized, interventions aiming at dealing with the loss of smell as a source of information and enjoyment, as well as at improvement of emotional wellbeing, social interaction, energy, and depression should be considered.

[Quality of life and voice intelligibility in laryngeal cancer patients--relevance of the "satisfaction paradox"]. / Lebensqualität und Sprachverständlichkeit bei Patienten mit Kehlkopfkarzinom--Relevanz des "Zufriedenheitsparadoxes".

BACKGROUND: Aim of this study was to compare postoperative quality of life and voice intelligibility of laryngeal cancer patients. PATIENTS AND METHODS: Two studies assessed the quality of life (by EORTC QLQ-C30 and EORTC QLQ-H&N35) and the voice intelligibility (by PLTT and FPAL) of 218 laryngectomized and 151 partially resected patients. The data of 86 patients was analysed on the basis of matched pairs (matching criteria: sex and tumour stage). RESULTS: The smelling and tasting of the laryngectomized patients were more affected. Other domains of quality of life did not differ significantly between the groups. The subjective assessment of voice intelligibility led to worse results among the patients with partial laryngectomy, although the objective test proved the contrary. CONCLUSIONS: Subjective and objective assessment of quality of life can differ, which led to paradox results in this study, especially for voice intelligibility. This might be due to the fact that partially resected patients have higher expectations of their operation.

Case of ageusia from a variety of causes.

We report a case of a 31-year-old woman with ageusia. Her ageusia was related to a variety of causes including an unbalanced diet, administration of the anti-epileptic drug, carbamazepine and psychological factors. Her taste function recovered after stopping the carbamazepine and treatment with liver extracts and zinc sulphate.

The effects of loss of taste and smell in a case of anorexia nervosa and bulimia nervosa.

A woman with a mixed eating disorder is reported. Her disorder did not remit after a head injury which caused her to lose her sense of taste and smell.