Health Mindset and Psychosocial Factors in Patients with Sellar Pathology Undergoing Transsphenoidal Surgery

Introduction: Health mindset and optimism have been associated with differential outcomes in both surgical and medical conditions, often through the mediating effects of health literacy and self-efficacy. A ‘growth mindset’, defined as the belief that abilities and behaviors can improve over time, has been associated with improved outcomes compared to a more rigid or ‘fixed’ mindset, which views abilities as unchangeable. However, limited research has examined the role of health mindset in patients with skull base pathologies. This pilot study aimed to characterize mindset, symptom burden, and demographics in a cohort of patients undergoing endoscopic transsphenoidal surgery (ETSS) for sellar pathology. Methods: Adult patients (n = 14, ≥18 years) with sellar lesions undergoing ETSS were retrospectively reviewed. Preoperatively, patients completed the Health Mindset Survey (HMS), Revised Life Orientation Test (LOT-R), Brief Health Literacy Screen (BHLS), and Perceived Health Competence Scale (PHCS), which assess health mindset, optimism, literacy, and self-efficacy, respectively. Higher scores correspond with more positive health perspectives. Clinical and demographic data were collected alongside Sinonasal Outcome Test (SNOT-22) and Skull Base Inventory (SBI) responses. Statistical analyses (ANOVA, paired t-tests, and linear correlation) were performed using Excel and R Studio to evaluate relationships between psychosocial measures, clinicodemographic variables, and disease-specific quality-of-life (QoL) outcomes. Results: Fourteen patients (8M:6F) were included, with a mean age of 50 ± 23 years. Mean scores were HMS (mindset) 16.1 ± 2.5, LOT-R (optimism) 16.3 ± 5.4, BHLS (literacy) 13.0 ± 2.1, and PHCS (self-efficacy) 14.0 ± 2.8. Patients with incidentally discovered compared to symptomatic lesions had higher scores for mindset (17.0 ± 1.7 vs. 15.8 ± 2.6), literacy (14.0 ± 0.0 vs. 12.7 ± 2.3), and self-efficacy (16.0 ± 2.6 vs. 13.5 ± 2.7), though none were statistically significant (all p > 0.05). Additionally, this group reported significantly lower sinonasal (SNOT-22: 0.0 vs. 20.5 ± 14.9) and skull base symptom burden (SBI: 97.8 ± 2.0 vs. 73.7 ± 13.3; all p < 0.05). Increasing age was strongly correlated with increased optimism and self-efficacy (r = 0.78 and r = 0.66, p 0.05). A ‘growth mindset’ (higher HMS score) significantly correlated with higher SBI (r = 0.69, p