Large olfactory groove meningiomas

Abstract

Olfactory groove meningiomas (OGMs) account for 4.5 to 13% of all intracranial meningiomas (1,2). They arise in the anterior cranial fossa at the cribriform plate of the ethmoid bone and the area of the suture adjoining the planum sphenoidale. We performed a large retrospective study of 98 patients (59 females and 39 males) evaluated and operated in the Neurosurgical Department of the National Institute of Neurology and Neurovascular Diseases between 1979 – 2009. This represented 7.93% of all intracranial meningiomas operated in our department (1235 cases). These operations were done by or under the supervision of the senior neurosurgeon (LD). For the surgical removal of the OGMs we used both frontolateral (67 cases) or bifrontal approaches (31 cases). We achieved total removal of the meningioma in most of the cases (93.9%), meaning in 66 patients operated through unilateral frontolateral craniotomy (98.5%), and in 26 patients operated through bifrontal craniotomy (83.9%). As postoperative complications, were encountered: subdural hygroma, postoperative hemorrhage, cerebrospinal fluid (CSF) leak, postoperative seizures, diffuse cerebral edema and local infection. Postoperative mortality was 7.14% (7 patients). Frontolateral approach allowed, even in large OGMs, very good postoperative results, with high rates of total tumor resection and low rates of morbidity and mortality.

Keywords

• bifrontal approach
• frontolateral approach
• meningioma
• olfactory groove
• recurrence