Meningiomas del surco olfatorio. Tratamiento microquirúrgico radical por vía bifrontal

González-Darder, José M.; Pesudo-Martínez, J.V.; Bordes-García, V.; Quilis-Quesada, Vicent; Talamantes-Escrivá, F.; González-López, Pablo; Masbout-Kayal, G

doi:10.1016/s1130-1473(11)70011-2

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…Several surgical techniques have been proposed for their transcranial removal;[ 1 14 22 24 26 45 47 51 54 ] they rely on either a frontal or fronto-lateral trajectory and typically wide bone excisions in order to create a suitable surgical corridor leading to the anterior cranial fossa. Regardless of the trajectory or extent of bone removal, all these techniques require a certain degree of brain retraction to reach their target; this maneuver may add injury to an already compromised cerebral tissue, potentially preventing a full neurological recovery or even increasing the intensity of previously established changes.…”

Section: Discussionmentioning

confidence: 99%

“…Several approaches have been proposed for the transcranial resection of these tumors, with varying results;[ 1 3 14 22 23 24 25 26 40 42 44 45 47 50 51 52 53 54 57 ] the postoperative course of these techniques and their impact on cerebral tissue and patient neurological morbidity has also been documented to a certain extent. [ 4 8 9 21 55 ] Conversely, the use of endoscopic endonasal approaches (EEAs) for tumors arising from the anterior cranial fossa has also been well described.…”

Section: Introductionmentioning

confidence: 99%

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Magnetic resonance imaging fluid-attenuated inversion recovery sequence signal reduction after endoscopic endonasal transcribiform total resection of olfactory groove meningiomas

et al. 2015

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Background:Olfactory groove meningiomas grow insidiously and compress adjacent cerebral structures. Achieving complete removal without further damage to frontal lobes can be difficult. Microsurgical removal of large lesions is a challenging procedure and usually involves some brain retraction. The endoscopic endonasal approaches (EEAs) for tumors arising from the anterior fossa have been well described; however, their effect on the adjacent brain tissue has not. Herein, the authors utilized the magnetic resonance imaging fluid attenuated inversion recovery (FLAIR) sequence signal as a marker for edema and gliosis on pre- and post-operative images of olfactory groove meningiomas, thus presenting an objective parameter for brain injury after surgical manipulation.Methods:Imaging of 18 olfactory groove meningiomas removed through EEAs was reviewed. Tumor and pre/postoperative FLAIR signal volumes were assessed utilizing the DICOM image viewer OsiriX®. Inclusion criteria were: (1) No previous treatment; (2) EEA gross total removal; (3) no further treatment.Results:There were 14 females and 4 males; the average age was 53.8 years (±8.85 years). Average tumor volume was 24.75 cm3 (±23.26 cm3, range 2.8–75.7 cm3), average preoperative FLAIR volume 31.17 cm3 (±39.38 cm3, range 0–127.5 cm3) and average postoperative change volume, 4.16 cm3 (±6.18 cm3, range 0–22.2 cm3). Average time of postoperative scanning was 6 months (range 0.14–20 months). In all cases (100%) gross total tumor removal was achieved. Nine patients (50%) had no postoperative FLAIR changes. In 2 patients (9%) there was minimal increase of changes postoperatively (2.2 cm3 and 6 cm3 respectively); all others demonstrated image improvement. The most common complication was postoperative cerebrospinal fluid leakage (27.8%); 1 patient (5.5%) died due to systemic complications and pulmonary sepsis.Conclusions:FLAIR signal changes tend to resolve after endonasal tumor resection and do not seem to worsen with this operative technique.

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