Long-Term Quality-of-Life Outcomes After Endoscopic Resection of Sinonasal and Skull Base Tumours: A Systematic Review and Meta-Analysis

INTRODUCTION: The present meta-analysis and systematic review aims to address the gap by examining long-term quality-of-life outcomes following endoscopic resection of sinonasal and skull base tumours. Materials and procedures: We searched databases such as PubMed, Scopus, Embase, and Google Scholar for research publications published between 2005 and 2024, following the PRISMA guidelines. R software was used to perform the meta-analysis, and Cochrane's ROB 2.0 tool was employed to assess the risk of bias in the included studies. The I² statistic was used to evaluate heterogeneity. A funnel plot, along with Egger's regression test, was used to assess publication bias. RESULTS: The meta-analysis showed that quality of life (QOL) typically declined shortly after surgery, with a statistically significant worsening indicated by the SNOT-22 score (standardized mean difference [SMD] 0.49; 95% CI: 0.01 to 0.96) and a non-significant change on the ASBQ score (SMD -2.72; 95% CI: -10.93 to 5.49). However, results from the SNOT-20 score suggested a non-significant immediate improvement (SMD -4.70; 95% CI: -23.95 to 14.55). In the long term, patients experienced a clear and statistically significant overall improvement in QOL (p < 0.01), reflected by reductions in SNOT-22 (SMD -0.23; 95% CI: -0.61 to 0.14) and SNOT-20 scores (SMD -5.46; 95% CI: -26.93 to 16.02), alongside an increase in ASBQ scores (SMD 0.77; 95% CI: -2.18 to 3.71). CONCLUSION: Endoscopic resection of sinonasal and skull base tumours significantly improves postoperative sinonasal quality-of-life (QOL) symptoms. Although symptoms may temporarily worsen during the perioperative period, most patients generally return to baseline QOL in the long term.