Operative Management of Olfactory Groove Meningioma: Five Years’ Experience

Authors

  • Zahid Khan Department of Neurosurgery, PGMI, LRH, Peshawar
  • SEEMA SHARAFAT Department of Neurosurgery
  • MUMTAZ ALI Department of Neurosurgery
  • Khalid Khanzada Khan Department of Neurosurgery
  • Shahid Ayub Department of Neurosurgery

Keywords:

Intracranial meningioma, olfactory groove meningioma, bifrontal craniotomy, anterior skull base

Abstract

Objective: To analyze patients operated for olfactory groove meningioma during five years’ times.
Methods: This observational study was conducted in the department of neurosurgery, postgraduate medical institute lady reading hospital Peshawar. The clinical records of the patients were analyzed and data regarding clinical presentation, imaging studies, surgical and histological records, discharge letters and follow-up were noted.
Results: A total of 168 patients with meningiomas were operated between January 2007 and December 2011 in the department. There were 24 patients with olfactory groove meningiomas, including 18 women and 6 men with a mean age of 52.6 years (range, 26-75 years). Most patients presented with headache 22 (91.6%) followed by decrease vision in 12 (50%) cases and mental disturbancein 6 (25%) patients. Most of the patients 7 (29.2%) had either large or giant14 (58.3%) meningioma.there were 23 patients operated through the bifrontal and 1 through the frontolateral approach. Total tumor removal (Simpson Grade 1 or 2) was achieved in most cases 21 (87.5%). Perioperative mortality was in one patient and morbidity in 33.3% cases. The overall recurrence rate was 4.2% (1 out of 24) during the study period.
Conclusion: Olfactory groove meningiomas were removed mainly through bifrontal approach. Through this approach even large tumors could be removed with low recurrence rate but had high mortality rate. However for some small meningioma frontolateral resection could be achieved which provides quick access to the tumor with less brain exposure with a low morbidity rate and no mortality but had high recurrence.

References

1. Colli BO, Carlotti CG Jr, Assirati JA Jr, Santos MB, Neder L, Santos AC and et al. Olfactory groove menin-giomas: surgical technique and follow-up review. Arq Neuropsiquiatr. 2007 Sep; 65 (3B): 795-9.
2. Nakamura M, Struck M, Roser F, Vorkapic P, Samii M. Olfactory groove meningiomas: clinical outcome and recurrence rates after tumor removal through the fronto-lateral and bifrontal approach. Neurosurgery. 2007; 60: 844–852. [PubMed]
3. Hentschel SJ, DeMonte F. Olfactory groove meningio-mas. Neurosurg Focus. 2003 Jun 15; 14 (6): e4.
4. Pepper J, Hecht SL, Gebarski SS, Lin EM, Sullivan SE, Marentette LJ. Olfactory groove meningioma: discuss-ion of clinical presentation and surgical outcomes follo-wing excision via the subcranial approach. Laryngo-scope. 2011; 121: 2282–2289. [PubMed]
5. Jung JJ, Warren FA, Kahanowicz R. Clin Ophthalmol. 2012; 6: 339-42. Epub 2012 Mar 5. Bilateral visual loss due to a giant olfactory meningioma.
6. Ciurea AV, Iencean SM, Risea RE, Brehar FM. Olfac-tory groove meningiomas. A retrospective study of 59 surgical cases. Neurosurg Rev. 2011 Sep 30; [Epub ahead of print.]
7. Nakamura M, Struck M, Roser F, Vorkapic P, Samii M. Olfactory groove meningiomas: clinical outcome and recurrence rates after tumor removal through the fronto-lateral and bifrontal approach.Neurosurgery. 2008 Jun; 62 (6 Suppl 3): 1224-32.
8. Obeid F, Al-Mefty O. Recurrence of olfactory groove meningiomas. Neurosurgery. 2003 Sep; 53 (3): 534-42; discussion 542-3.
9. Kida s, Yamashima T, Kubota T, et al. A light and elec-tron microscopic and immunohistochemical study of human arachnoid villi. J Neurosurg 1988; 69: 429-35.
10. Gardner PA, Kassam AB, Thomas A, Snyderman CH, Carrau RL, Mintz AH, Prevedello DM. Endoscopic endonasal resection of anterior cranial base meningio-mas. Neurosurgery. 2008 Jul; 63 (1): 36-52; discussion 52-4.
11. Al-Mefty O (ed.). Meningiomas. New York, NY: Ra-ven press; 1991.
12. de Divitiis E, Esposito F, Cappabianca P, Cavallo LM, de Divitiis O, Esposito I. Endoscopic transnasal resec-tion of anterior cranial fossa meningiomas.Neurosurg Focus. 2008; 25 (6): E8.
13. Spektor S, Valarezo J, Fliss DM, Gil Z, Cohen J, Gold-man J, Umansky F. Review Olfactory groove menin-giomas from neurosurgical and ear, nose, and throat perspectives: approaches, techniques, and outcomes. Neurosurgery. 2005; 57 (4): 268-80.
14. Bakay L, Cares HL. Olfactory meningiomas report on a series of twenty – five cases. Acta Neurochir (Wien) 1972; 26: 1–12. [PubMed]
15. Bahy K. Validity of the frontolateral approach as a minimally invasive corridor for olfactory groove meni-ngiomas. Acta Neurochir (Wien). 2009 Oct; 151 (10): 1197-205.
16. Nakamura M, Roser F, Struck M, Vorkapic P, Samii M. Tuberculum sellae meningiomas: clinical outcome con-sidering different surgical approaches.Neurosurgery. 2006 Nov; 59 (5): 1019-28; discussion 1028-9.
17. Romani R, Lehecka M, Gaal E, Toninelli S, Celik O, Niemelä M, Porras M, Jääskeläinen J, Hernesniemi J. Lateral supraorbital approach applied to olfactory gro-ove meningiomas: experience with 66 consecutive pati-ents. Neurosurgery. 2009 Jul; 65 (1): 39-52; discussion 52-3.

Downloads

Published

2018-10-09

Issue

Vol. 16 No. 1 (2012): January-June

Section

Original Articles

License

The work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).