Objective: Meningiomas have various clinical presentations, and skull base meningioma harbors
the most diversified symptoms of them. Many outcome-predicting factors for skull base
meningiomas were profoundly discussed. However, we have yet to see a single predicting
factor, which was easy to be evaluated preoperatively and was able to predict both
functional and clinical outcomes. Our objective of this study was to examine the correlation
between a single category of preoperative symptoms and outcomes of skull base meningiomas
after multimodality treatments.
Material and Methods: The authors retrospectively reviewed the medical records and radiological data to
obtain outcomes of patients who underwent treatments at our institute for their skull
base meningiomas during 2010–2018. The analyses were designed to address the association
among the preoperative cranial nerve deficits (CNDs), functional outcomes, and survival
prognosis.
Results: A total of 143 patients were included with the median follow-up time of 27.3 months.
Mostly mentioned chief complaints were eye symptoms (32.2%), unsteady gait (29%),
headache (15.4%), and dizziness (7.7%). Eighty-one patients (56.6%) presented with
preoperative CNDs, of which were smelling dysfunctions (CN1, 2.5%), eye symptoms (CN2–4,
54.8%), facial pain (CN5, 9.5%), facial palsy and tinnitus or hearing loss (CN7–8,
22.6%), and swallowing difficulties (CN9–12, 3.6%). The presentation of preoperative
CNDs was associated with new onset or worsen postoperative CNDs (p < 0.001), tumor recurrence (p = 0.019), and requirements of adjuvant therapies (e.g., gamma knife surgeries or
endoscopic endonasal surgeries, p = 0.006). The mean resection rate of patients with and without preoperative CNDs
were 90 and 97%, respectively, (p < 0.0001). It may also correlate to a longer progression-free survival (p = 0.03), independent to the pathological grading (p = 0.25).
Conclusion: The presentation of preoperative CNDs may be considered as an outcome predictor for
skull base meningiomas.
