Quality of Life After Endoscopic Endonasal vs. Open Resection of Skull Base Meningioma: A Systematic Review and Meta-Analysis

Year 2025, Volume: 8 Issue: 3, 131 - 141, 23.12.2025

Bhupesh Gupta , Kirtika Gupta Rajdeep Singh Shilpi Gupta Ginni Dutta Anshu Mittal

https://doi.org/10.65396/ejra.1716492

https://izlik.org/JA48TS92FT

Abstract

Background: The optimal surgical approach for skull base meningioma remains debated with respect to long-term quality of life (QOL). Objective: To compare postoperative QOL across sinonasal, cognitive, and general health domains using standardized mean differences (SMD) relative to normative populations.
Methods: Systematic review and meta-analysis of 26 studies (2,567 patients) identified via PubMed, Embase, and Scopus (inception to March 15, 2025). Hedges’ g was calculated using validated QOL instruments with normative data. Random-effects modeling, subgroup, meta-regression, and sensitivity analyses were performed.
Results: Surgery was associated with large QOL impairment (SMD = 0.82, 95% CI: 0.59–1.05, P < 0.001; I² = 92%). Sinonasal QOL showed the largest deficit (SMD = 1.11), followed by general health (SMD = 0.00), cognition (SMD = 0.02), and functional status (SMD = -0.26) (P for interaction < 0.001). No approach-specific differences were identified. Trim-and-fill adjusted SMD to 0.64.
Conclusion: Skull base meningioma resection significantly impairs QOL, particularly sinonasal function, regardless of surgical approach. These findings guide patient counseling and surgical decision-making.

Keywords

Sinonasal , quality of life , endoscopic endonasal , meningioma , open surgery

Ethical Statement

Since the study involves a meta-analysis and systematic review, ethical approval was not needed. PROSPERO gave its approval to this study.

Thanks

Author’s Contribution: BG, SG, and KG: the article's idea, layout, and typological reasoning. BG, RS, and KG: data collection and literature selection. BG, KG, and AM: data interpretation and analysis; article editing. BG, AM, and SG: supervision of the study and paper revision. The submitted version of the article was approved by all authors who contributed to it.

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