Abstract
Endoscopic skull base surgery has transformed craniofacial treatment by reducing morbidity and enhancing precision. Traditional outcome measures often overlook the multidimensional aspects of quality of life (QoL) in recovery. Patient-reported tools, such as the anterior skull base questionnaire (ASBQ), offer a comprehensive view of QoL. However, the ASBQ's effectiveness is limited in non-English-speaking populations without cultural adaptation. This study aims to culturally adapt and psychometrically validate the Persian version of the anterior skull base questionnaire (ASBQ-P) for patients undergoing transnasal transsphenoidal surgery. Translation and cross-cultural adaptation adhered to ISPOR guidelines, encompassing forward and backward translation, expert review, and cognitive debriefing. Internal consistency was evaluated through Cronbach's α, and test-retest reliability was assessed using intraclass correlation coefficients (ICCs). Convergent validity was assessed using Pearson's correlation with SNOT-22 scores, while responsiveness was evaluated through effect sizes and standardized response means. Statistical analyses were performed using SPSS version 27, with a significance threshold set at P < 0.05. A total of 36 patients completed the Persian version of the ASBQ and SNOT-22 questionnaires. The ASBQ demonstrated excellent internal consistency (Cronbach's α = 0.936). Test-retest reliability was high, with an ICC of 0.927 for average measures. Convergent validity was supported by a significant moderate negative correlation between ASBQ and SNOT-22 scores (r=-0.544, P = 0.001). A known-groups validity analysis revealed significant differences in ASBQ scores across SNOT-22 severity categories (P = 0.001), supporting the instrument's discriminative capacity. Our findings confirm the Persian ASBQ as a reliable and valid tool for assessing outcomes in anterior skull base surgery.