Romanian Neurosurgery (Nov 2024)
THE OLFACTORY GROOVE MENINGIOMA
Abstract
Objectives This presentation aims to discuss the surgical approaches for resecting an olfactory groove meningioma in the hope of determining which one is the best. Olfactory groove meningiomas (OGMs) are arachnoid cell neoplasms of the frontoethmoidal suture and lamina cribrosa. Arising along the midline of the anterior fossa, OGMs frequently impinge on the frontal lobes through mass effect. As the growth enlarges, displacement of adjacent brain regions leads to headaches, fatigue, seizures, and intracranial hypertension and most importantly, anosmia. In this presentation, the surgical approaches for resecting this kind of tumour are discussed in hope of determining which one is the best. Surgical approaches to olfactory groove meningiomas vary based on the tumour’s size, location, and relationship to surrounding structures. The choice of surgical approach depends on: • a) Tumour size and location - larger or more complex tumours may require extensive transcranial approaches; • b) The surgeon’s expertise; • c) The patient’s health (considering the patient's overall health, recovery expectations, and potential risks). Methods By conducting a PubMed search of the recent literature (2019-2024) and drawing on the expertise of the Department of Neurosurgery at Bucharest’s Emergency Hospital, we examined the optimal surgical approaches for treating this type of tumor. Results There are four main methods to consider when confronting an OGM, each one with its advantages and disadvantages. • Transcranial Approaches • The Subfrontal Approach (unilateral and bilateral) • Through an Eyebrow supraorbital keyhole craniotomy • The Endoscopic Endonasal Approach • Through a Pterional (Frontotemporal) Craniotomy • The Extended Bifrontal Approach The key idea that was enhanced in most of the articles throughout our research is that each approach is suited in different circumstances and that, patient selection is one of the most important steps when dealing with an OGM. Conclusions Ultimately, the surgical approach is tailored to the individual patient’s needs, balancing the goals of complete tumour removal with minimizing risks and preserving neurological function.
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