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CURRENT ISSUEJOURNAL OF NEUROSURGICAL SCIENCES

A Journal on Neurosurgery

Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,651

Frequency: Quarterly

ISSN 0390-5616

Online ISSN 1827-1855

 

Journal of Neurosurgical Sciences 2015 Mar 10

Following the canyon to reach and remove olfactory groove meningiomas: surgical experience

Stefini R. 1, Zenga F. 3, Esposito G. 1, Bolzoni A. 2, Tartara F. 4, Spena G. 1, Ambrosi C. 5, Fontanella M. M. 1

1 Departments of Neurosurgery, Spedali Civili, University of Brescia, Italy;
2 Departments of Otorhinolaryngology, Spedali Civili, University of Brescia, Italy;
3 Department of Neurosurgery, Azienda Ospedaliera-­Universitaria San Giovanni Battista, Turin, Italy;
4 Department of Neurosurgery, Azienda Ospedaliera “Istituti Ospedalieri”, Cremona, Italy;
5 Department of Neuroradiology, Spedali Civili, University of Brescia, Italy

Olfactory groove meningiomas (OGMs) represent approximately 10% of all intracranial meningiomas. They arise in the olfactory fossa, a variable depression delimited by the lateral lamella and perpendicular plate. The cribriform plate with the lateral lamella and ethmoidal and orbital roof could be viewed as a ‘canyon’ with the frontal sinus as the main entrance. ​Between January 2000 and December 2013, 32 consecutive patients underwent removal of OGMs through this ‘canyon’ at the Department of Neurosurgery of Brescia and Turin. Complete removal was achieved in all patients with this trans-frontal sinus subcranial approach (Simpson grade I; mean 3​ lesion volume, 46.6 cm​). Five patients (15.6%) experienced nasal CSF leakage, treated with external lumbar drain positioning for 4 days and resolved in all cases but one, which was re-operated. Two patients (6.2%) during the CSF leakage experienced meningitis at day 7 after surgery, both successfully treated by intravenous antibiotic therapy. After one month, one patient developed hydrocephalus, treated with a ventricular peritoneal shunt. In one patient, traction on the OGM caused bleeding of the callosomarginal artery, which was coagulated with superior frontal gyrus ischemia without neurological consequences. Glasgow Outcome Scale score at 6 months was V in 29 patients, IV in one patient, and I in two patients. Advantages with ​this approach may include easy and early control of blood supply from its insertion in the skull base, minimal frontal lobe retraction, preservation of the frontal veins draining to the sagittal sinus, and a satisfactory aesthetic outcome.

language: English


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