Olfactory groove meningiomas: surgical technique and follow-up review

Abstract

-Background: Olfactory groove meningiomas comprise 4-10% of the intracranial meningiomas. Generally they give signs of brain compression due to great size they reach before diagnosis. In this study, the clinical outcome of patients with olfactory groove meningiomas surgically treated was analyzed. Method: 17 patients operated on from 1988-2006. Follow-up: 1-209 months (mean=51.07±12.73. Bifrontal/bifrontal-bi-orbital approaches were used. Outcome was analyzed using survival/recurrence-free Kaplan-Mayer curves. Results: 16 had WHO grade 1; one grade 2 meningiomas. resection Simpson's grade 1 was in achieved in 64.7%, grade 2 in 29.4% and grade 3 in 5.9%. there was no recurrence during the follow-up. Global and operative mortality were 11.8%. Main postoperative complications were osteomielitis (11.8%) and pneumonia (5.9%). Conclusion: Extensive approaches allowed total resection of most olfactory groove meningiomas with no recurrence during the follow-up, but operative mortality and local complications were high.KEy WOrdS: olfactory groove meningiomas, surgical treatment, survival curves.Meningiomas da goteira olfatória: técnica cirúrgica e resultados rESuMO -Introdução: Os meningiomas da goteira olfatória constituem 4-10% dos meningiomas intracranianos. Geralmente eles causam sinais de compressão do tronco cerebral porque atingem grandes tamanhos antes do diagnóstico. Neste estudo foram analisadas os resultados do tratamento cirúrgico de pacientes com meningiomas da goteira olfatória. Método: 17 pacientes operados de 1988-2006. Mulheres: 16. Homens: 1. Idade: 19-76 anos (média=53,12±13,11). Seguimento: 1-209 meses (média=51,07±12,73. Foram utilizados acessos bifrontal/bifrontal bi-orbital. A evolução clinica foi analisada usando curvas de sobrevida e de sobrevida livre de doença de Kaplan-Mayer. Resultados: 16 pacientes tinham meningioma WHO grau 1; um tinha meningioma grau 2. ressecção Simpson grau 1 foi obtida em 64.7%, grau 2 em 29.4% e grau 3 em 5.9%. Não houve recidiva durante o seguimento. A mortalidade global e a pós-operatória foram 11.8%. As principais complicações pós-operatórias foram osteomielite (11.8%) e pneumonia (5.9%). Conclusão: Abordagens extensas possibilitaram ressecção total da maioria dos meningiomas da goteira olfatória sem recidiva durante o seguimento, mas a mortalidade operatória e as complicações locais foram altas.PAlAvrAS-cHAvE: meningiomas da goteira olfatória, tratamento cirúrgico, curvas de sobrevida.

Supra-orbital keyhole removal of anterior fossa and parasellar meningiomas

“…They reported that a small frontolateral approach provided best results concerning visual outcomes than the pterional and subfrontal approaches, and similar results regarding rates of total tumor removal 20,21 . The results of gross total resection of anterior cranial fossa meningiomas reported in the literature, as well as ours (83.3%), obtained after minimally invasive approaches to these tumors have similar results to traditional craniotomy series 20,[22][23][24][25][26][27] . Recently, Reisch and Perneczky reported their experience using the supraorbital eyebrow approach for the treatment of 93 anterior and medial fossa meningiomas.…”

The extended pterional approach allows excellent results for removal of anterior cranial fossa meningiomas

“…They claimed that the frontolateral and pterional approaches provide remarkable improvement compared with the bifrontal approach. To decrease tumor recurrence, some authors recommend cranial base approaches such as uni or bilateral orbital osteotomy and cranial base drilling and reconstruction 2,5,8,16,25 . The demographic characteristics of the patients in this series did not influence the results.…”

“…OGMs are a subset of meningiomas that grows over the cribiform plate and the frontosphenoidal suture. They represent 8-18% of all intracranial meningiomas 1,2,3,4,5 . OGMs displace the optic nerve (ON) and the chiasm inferiorly and posteriorly.…”

Pterional and unifrontal approach for the microsurgical resection of olfactory groove meningiomas: experience with a series of 61 consecutive patients

“…The differentiation from meningiomas of the planum sphenoidale and tuberculum sellae is of clinical and surgical importance; tumors arising from these sites are usually diagnosed at an early stage due to visual impairment, which is a late finding in OGMs (7,11,22,28).…”

“…This feature is rarely observed in planum █ INTRODUCTION O lfactory groove meningiomas (OGMs) account for 4-13% of all intracranial meningiomas. They originate from the dura of the anterior cranial fossa over the cribriform plate and frontosphenoidal suture (7,10,11,25,36).OGMs usually present with hypo/anosmia, visual deterioration, mental changes and headache as a result of olfactory or optic nerve and frontal lobe compression. Seizures are also common in these patients (8,33).…”