Feasibility of the frontobasal interhemispheric approach for managing large olfactory groove meningiomas | ||||
| Pan Arab Journal of Neurosurgery | ||||
| Article 8, Volume 17, Issue 1, June 2022, Page 49-55 PDF (530.94 K) | ||||
| Document Type: Original Articles | ||||
| DOI: 10.21608/pajn.2021.95341.1036 | ||||
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| Authors | ||||
Mohamed Atef Elnokaly   1; Tamer Mohamed El Sanadidy2; Mohammed M Adawi2
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| 1Department of Neurosurgery, Faculty of Medicine, Helwan university, Cairo, Egypt. | ||||
| 2Department of Neurosurgery, Faculty of Medicine, Benha University, Benha, Egypt. | ||||
| Abstract | ||||
| Background: Olfactory groove meningiomas develop into enormous sizes at the time of diagnosis. This favors a wide surgical corridor to ease surgical excision. The frontobasal interhemispheric approach is a feasible variant sparing additional unwanted frontal lobe traction aiming for better functional outcome. Aim of work: We aim for analyzing the feasibility and safety of the approach in managing large olfactory groove meningiomas. Patients and Methods: Retrospective study of 15 consecutive patients with large olfactory groove meningiomas ( maximum diameter ≥ 4cm) managed between 2016-2020. We analyzed functional surgical outcome with respect to patient performance, Karnofsky Performance Status scores (KPS), and cognitive status, Mini-Mental State Examination (MMSE). Results: Our records show we operated on 12 females and 3 males with an age range 39-64 years (mean age:50.4). No major complications were encountered. Three patients had minor complications (20%). The mean postoperative KPS score (81.6±2.4) was significantly improved. Cognitive impairment was reported in 7 patients, with varying MMSE. Improvements seen in all 5 cases with mild impairment, however, one patient with severe impairment needed further cognitive consultation and support. As regards visual outcome, unfortunately no patients with pre-operative reported visual deficits had any improvements, with no reported worsening to preoperative vision. Conclusion: The interhemispheric approach could be considered a safe and quite feasible approach for managing large olfactory groove meningiomas with an accepted impact on post-operative patient performance. | ||||
| Keywords | ||||
| Olfactory groove; transbasal; interhemispheric; meningioma; skull base | ||||
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