Bhupesh GUPTA, Kirtika GUPTA, Shilpi GUPTA, Ginni DATTA, Anshu MITTAL
European Journal of Rhinology and Allergy - 2025;8(3):131-141
OBJECTIVE: The optimal surgical approach for skull base meningioma remains debated regarding long-term quality of life (QOL). Objective: To compare postoperative QOL across sinonasal, cognitive, and general health areas using standardized mean differences (SMD) compared to normative populations. METHODS: Systematic review and meta-analysis of 26 studies (2,567 patients) identified via PubMed, Embase, and Scopus (up to March 15, 2025). Hedges' g was calculated using validated QOL instruments with normative data. Random-effects modeling, subgroup analyses, meta-regression, and sensitivity analyses were performed. RESULTS: Surgery was linked to significant QOL impairment (SMD = 0.82, 95% CI: 0.59-1.05, P < 0.001; I² = 92%). Sinonasal QOL experienced the most significant decline (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 differences were found based on approach. The trim-and-fill adjusted SMD was 0.64. CONCLUSION: Skull base meningioma resection significantly impairs QOL, especially sinonasal function, regardless of surgical approach. These findings inform patient counseling and surgical decision-making.
