Functional Outcome of Operated Patients with Skull Base Meningioma in a Tertiary Care Center in Nepal: A Retrospective Analysis

Abstract

Introduction:Surgery for skull base meningiomas (SBM) has been a challenge to neurosurgeons owing to their location and intimate relation with adjacent neurovascular structures. Many studies have shown higher approach-related morbidity as surgeon’s affinity towards radical surgery. There are only few studies focused on SBM and its functional and neurological outcome. In this study, we have attempted to probe the demographics, histopathology, location, extent of resection and functional outcome of SBM after surgery.

Methods:This is a three-year retrospective analysis of SBM surgery performed at our hospital from July 2019 to June 2022.Clinical manifestations, neurological deficits, tumor characteristics,  Karnofsky Performance score (KPS) and Medical Research Council Neurological Performance score (MRC-NPS) before and after surgery were analyzed by collecting patient data from hospital medical records, telephone questionnaire and hospital pathological records. Statistical analysis of functional outcome using preoperative and postoperative KPS and MRS-NPS scores was done using Paired t-test.

Results:We analyzed 65 patients with SBM who underwent craniotomy. Common histopathological subtype was found to be transitional (20) and meningothelial (19). On the basis of WHO CNS tumor classification, majority of cases (55/65, 84.6%) belong to grade 1. Complete excision rate in our series was 58.5%. Mortality rate in our series was 3.1%.  Regarding functional outcome, there was significant improvement in KPS (72.46 vs. 81.69; p=0.0001) and MRC-NPS (2.89 vs. 2.31; p=0.0001) before and 3 months after surgery.

Conclusion:SBM excision is associated with significant improvement in functional and neurological status after surgery based on preliminary data. However larger retrospective series is required for validation. However one should be cautious to avoid approach related morbidity.