Oral Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

From surgery to support: Enhancing multidisciplinary care pathways in skull base surgery (126638)

Joanne Hiatt 1 , Teresa Brown 1 2 , Ryan Sommerville 3 , Abigail Walker 3 , Clare Burns 4 , Laura Moroney 4 , Richard Gan 3 , Brett Hughes 5 6 , Judy Bauer 7
  1. Dietetics and Food Services, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia
  2. School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
  3. ENT Surgery, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia
  4. Speech Pathology, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia
  5. Cancer Care Services, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia
  6. School of Medicine, University of Queensland, Brisbane, Queensland, Australia
  7. Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia

Objectives/Purpose
The study aim was to explore the experiences of patients who have undergone skull base surgery, focusing on the roles of dietitians and speech pathologists in supporting eating and swallowing difficulties. It seeks to identify gaps in health service support and communication during perioperative and post-surgical care to inform more patient-centred, multidisciplinary service delivery.

Sample and setting
Eighteen adults who underwent skull base surgery (January 2018 – July 2024) at a tertiary hospital in Brisbane, Australia, were recruited via convenience sampling.

Procedures

A qualitative design using semi-structured interviews was used. Interviews were conducted by a dietitian not involved in participants’ care and analysed using reflexive thematic analysis. The study adhered to the COREQ checklist for qualitative research.

Results
The median age of participants was 61 years, with most being male (72%) and diagnosed with malignant tumours. Fourteen received adjuvant therapy, and participants came from rural, regional and metropolitan locations. Five key themes emerged: (1) Nutrition is not a priority—patients focused on survival, often overlooking dietary needs; (2) Limited awareness of allied health—uncertainty about the roles of dietitians and speech pathologists affected engagement; (3) Feeling disconnected post-discharge—patients reported and lack of follow-up; (4) Complexity of informed consent—patients struggled to absorb information pre-surgery; and (5) Social withdrawal—changes in function vulnerability and appearance led to social isolation.

Conclusion and clinical implications
The findings underscore the need for a holistic, patient-centred approach to skull base surgery care. Nutrition and allied health support were often undervalued due to limited awareness and engagement with staff. Enhancing perioperative education, integrating allied health professionals across the care continuum, and addressing psychosocial challenges are essential to improving recovery and quality of life in this patient group. These insights support the development of multidisciplinary strategies that address patients’ lived experience and healthcare needs.