gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Strategies for the operative therapy of olfactory groove meningiomas

Meeting Abstract

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  • D. Wachter - Abteilung für Neurochirurgie, Georg-August-Universität Göttingen
  • J.M. Gilsbach - Abteilung für Neurochirurgie, Klinikum der RWTH Aachen
  • V. Rohde - Abteilung für Neurochirurgie, Georg-August-Universität Göttingen; Abteilung für Neurochirurgie, Klinikum der RWTH Aachen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocSA.03.02

DOI: 10.3205/12dgnc322, URN: urn:nbn:de:0183-12dgnc3226

Published: June 4, 2012

© 2012 Wachter et al.
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Outline

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Objective: Several approaches have been proposed for microsurgical removal of olfactory groove meningiomas. The bifrontal and the orbitozygomatic approach are preferred by many with the disadvantage of sinus opening and extensive bone work. We alternatively used the pterional approach and the anterior interhemispheric approach to resect the tumor. It is our objective to compare the approaches with respect to operative results and complications.

Methods: A total of 62 patients underwent removal of an olfactory groove meningioma. In 28 patients, the right pterional and in the remaining 34 patients, the anterior interhemispheric approach was used. The case files were retrospectively reviewed with focus on clinical outcome, complication rate and tumor remnants.

Results: Using the pterional approach, complete tumor removal was achieved in 27 of 28 patients. In 6 of 8 patients, the visual field cuts and in 19 of 20 patients, the mental dysfunction improved after surgery. Two serious complications (symptomatic rebleed n=1, pulmonary embolism n=1) (7%) occurred. With the interhemispheric approach, complete tumor removal was possible in all patients, leading to visual field cut improvement in 4 of 5 patients and to mental dysfunction improvement in 11 of 12 patients. Wound infection, unrelated brain stem infarction and symptomatic rebleed complicated the postoperative course of 3 patients (9%).

Conclusions: Both approaches to olfactory groove meningiomas allow obtaining favorable surgical results. In comparison with other studies, the complication rate is low. Today, our preferred approach is the interhemispheric approach because of earlier devascularisation, better bilateral control of vital neurovascular structures and better visualisation of the tumor matrix.