Unilateral endonasal transcribriform approach with septal transposition for olfactory groove meningioma: can olfaction be preserved?

Youssef, A. Samy; Sampath, Raghuram; Freeman, Jacob; Mattingly, Carolyn J.; Ramakrishnan, Vijay R.

doi:10.1007/s00701-016-2922-1

Cited by 27 publications

(25 citation statements)

References 14 publications

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“…reported a series of 14 patients with unilateral esthesioneuroblastomas who underwent unilateral resection followed by radiation therapy, with 6 (43%) patients having some smell preservation following treatment completion. Youssef et al . reported a similar outcome in a patient who had an olfactory groove meningioma.…”

Section: Complicationsmentioning

confidence: 88%

“…Recently there have been reports in the literature of more tailored minimally invasive EEA to OGM . Youssef et al .…”

Section: Intradural Tumorsmentioning

confidence: 99%

“…Recently there have been reports in the literature of more tailored minimally invasive EEA to OGM . Youssef et al . presented a case report following a cadaveric study where a unilateral transcribriform approach with septal transposition was able to preserve preoperative olfaction.…”

Section: Intradural Tumorsmentioning

confidence: 99%

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

151

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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Section: Complicationsmentioning

confidence: 88%

“…Recently there have been reports in the literature of more tailored minimally invasive EEA to OGM . Youssef et al .…”

Section: Intradural Tumorsmentioning

confidence: 99%

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

151

279

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“…It affects our eating habits, provides protection against environmental hazards, contributes to interpersonal relationships, and ensures biological and psychological experiences. 27 Anosmia, although diagnosed in 13 to 65% of patients with OGMs, is rarely a symptom resulting in an OGM diagnosis. 7 Both slow growth and their localization contribute to a delayed clinical presentation of OGMs.…”

Section: Discussionmentioning

confidence: 99%

Olfaction in Olfactory Groove Meningiomas

Dedeciusová

Svoboda

Beneš

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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Background Clinical examination, including pre- and postoperative assessment of olfaction, is essential in evaluating surgical outcomes in patients with olfactory groove meningiomas (OGMs). A review of a recent series revealed a lack of assessment of olfaction in most of the studies. Tests determining olfactory detection should be used to reveal olfactory dysfunction. Specialized examination techniques (e.g., electro-olfactography, olfactory evoked potentials, and functional magnetic resonance imaging) are currently used in research. Methods Prospective analysis of 13 patients who underwent surgical resection of OGMs from December 2013 to December 2017 was performed. Data on clinical presentation, pre- and postoperative neurologic examinations, complications, recurrences, adjuvant treatment, and follow-up outpatient examinations were recorded. Olfactory function was assessed using the Sniffin' Sticks odor identification test preoperatively, postoperatively, and 1 year after surgery. Results All the meningiomas were resected via unilateral craniotomy, and gross total resection was achieved in all cases. Surgery-related permanent morbidity was 7.7% and overall mortality 0%. For the eight patients with preoperative normosmia, five remained normosmic (62.5%), one deteriorated to hyposmia (12.5%), and two deteriorated to anosmia (25%). For the two patients with preoperative hyposmia, one remained hyposmic and one deteriorated to anosmia. For the three anosmic patients, two remained anosmic, and one improved to hyposmia.The intact olfactory function preoperatively was associated with a better olfactory outcome. Overall, 62.5% of these patients remained normosmic, and none of the hyposmic or anosmic patients normalized their olfaction.Higher meningioma volume is associated with worse olfactory function before surgery (normosmia in 16.7% versus 100.0% in less voluminous) and following the surgery (normosmia in 16.7% versus 57.1% less voluminous).The unilateral surgical approach enabled the anatomical preservation of the contralateral olfactory nerve in 76.9% of our patients. Functional normosmia was achieved in 50% and hyposmia in 30% of these cases. Conclusions Assessment of olfactory function is both vital in preoperative decision making (surgical approach, radicality of resection) and when evaluating surgical outcome. Preoperative normosmia seems to be the most important prognostic factor for functional olfactory outcome. In normosmic patients the olfaction was preserved in 62.5% of cases. Moreover, higher meningioma volume is associated with worse olfactory function before and following the surgery. The greatest advantage of the unilateral surgical approach is anatomical preservation of the contralateral olfactory nerve with a satisfactory functional outcome. These results support a proactive approach, with early surgical resection using a unilateral approach even in cases with less voluminous OGMs that enables the preservation of olfactory function in a significant proportion of patients.

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“…Čich zajišťuje ochranu před nebezpečnými faktory prostředí, podílí se na mezilidských vztazích a ovlivňuje naše stravovací zvyky. Uvážíme-li, že čichová centra jsou významně propojena s limbickým systémem, poškození čichu může vést k významným psychofyziologickým změnám [54]. Čichové kortikální oblasti se významně překrývají s oblastmi odpovědnými za sociální funkce.…”

Section: Diskuzeunclassified

Olfactory groove meningiomas – surgical treatment, surgical risks and sense of smell preservation

Dedeciusová¹,

Májovský²,

Fundová³

et al. 2018

Cesk Slov Neurol N

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Olfaktoriální meningiomy-chirurgická léčba, její rizika a možnosti zachování čichu Olfactory groove meningiomas-surgical treatment, surgical risks and sense of smell preservation Souhrn Práce je zaměřena na poruchy čichu u pacientů s olfaktoriálními meningiomy (OGM). Přesné klinické vyšetření pacientů s OGM, včetně pre-a pooperačního zhodnocení čichu, je nezbytné pro hodnocení provedené chirurgické resekce. Článek poskytuje základní přehled recentních sérií OGM světových autorů. Jen malý zlomek z nich však dokumentuje přesné vyšetření čichu. Standardní vyšetření čichu by mělo stanovit čichovou detekci, diskriminaci a identifi kaci pomocí jednoho z užívaných testů (např. University of Pennsylvania Smell Identifi cation Test [UPSIT], The Single Staircase Odor Detection Treshold Test, Sniffi n' Sticks Test). Metodami vyšetření čichu, které jsou zatím využívány pro výzkum, zůstávají elektro-olfaktogram, čichové evokované potenciály a funkční magnetická rezonance. Zlatým standardem léčby OGM je chirurgická resekce. Volba vhodného operačního přístupu je stále kontroverzní a mezi jednotlivými autory nepanuje shoda. Nejčastěji se používá frontolaterální a pterionální přístup. Alternativou je endoskopická resekce, jejíž indikace jsou však omezené. Pooperační zachování čichu představuje zatím obtížný úkol.

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Unilateral endonasal transcribriform approach with septal transposition for olfactory groove meningioma: can olfaction be preserved?

Abstract: Olfaction preservation may be feasible in the endoscopic endonasal resection of a unilateral olfactory groove meningioma through a unilateral transcribriform approach with septal transposition and preservation of the contralateral olfactory apparatus.

Cited by 27 publications

References 14 publications

ICAR: endoscopic skull‐base surgery

ICAR: endoscopic skull‐base surgery

Olfaction in Olfactory Groove Meningiomas

Olfactory groove meningiomas – surgical treatment, surgical risks and sense of smell preservation

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