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CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0044-1791840
Original Article

Giant Olfactory Groove Meningiomas: A Case Series Demonstrating the Surgical Management and Functional Outcomes

Ashraf Elbadry
1   Department of Neurosurgery, Mansoura University Faculty of Medicine, Mansoura, Egypt
,
Azza Abdelazeez
2   Department of Pathology, Mansoura University Faculty of Medicine, Mansoura, Egypt
,
Mohamed Badran 
1   Department of Neurosurgery, Mansoura University Faculty of Medicine, Mansoura, Egypt
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Abstract

Objective Giant olfactory groove meningiomas (OGMs) present technical challenges in their management, especially when their size and location complicate the evaluation and planning process, making complete removal difficult. This study provides a comprehensive analysis of the surgical approaches and outcomes encountered in the management of giant OGMs at a single institution.

Materials and Methods This retrospective study evaluated surgical and functional outcomes in 71 patients diagnosed with giant OGMs larger than 6 cm. Tumors were excised using microsurgical resection via the bifrontal, pterional, or combined pterional and unifrontal approaches.

Results The study comprised 48 females (67.6%) and 23 males (32.4%), with a mean age of 54.1 years. The most common pathological type was meningothelial meningioma (45%). The bifrontal approach was the most frequently used (n = 47, 66.2%) and resulted in Simpson grade I or II resection in 41 patients (87.2%). The combined pterional and unifrontal approaches were used in 16 patients (22.5%), achieving Simpson grade I or II resection in 12 (75%). The pterional approach was the least commonly used (n = 8), with Simpson grade I or II resection achieved in 50% of these patients. Postoperatively, visual acuity and cognitive function improved during follow-up. Postoperative complications were frequently observed after the bifrontal approach. Three patients (4.2%) died.

Conclusion The bifrontal approach resulted in better resection of giant OGMs than other approaches but was associated with more complications. The combined pterional and unifrontal approach was superior to the pterional approach in terms of OGM resection, with no differences in complication rates. Significant postoperative improvements in functional outcomes, including visual acuity and cognitive function, were observed.

Keywords

giant - olfactory groove - meningioma - skull base - bifrontal approach

Ethical Approval

This study was reviewed and approved by the Institutional Review Board (IRB) of Mansoura University Faculty of Medicine (approval number: RP.24.08.993). The IRB is responsible for ensuring that research conducted at the institution adheres to ethical standards and protects the rights and welfare of potential research subjects. It is important to note that this article does not contain any studies involving human participants that were performed by any of the authors.


Authors' Contributions

All authors contributed to the conception and design of the study and reviewed and approved the final manuscript for submission and publication. The specific contributions were as follows: M.B., A.E., and A.A. were responsible for conceptualization. Methodology was led by M.B., while formal analysis and investigation were carried out by A.E., M.B., and A.A. The original draft was prepared by M.B., with both A.E. and M.B. involved in reviewing and editing. Resources were provided by A.E., M.B., and A.A., and supervision was managed by A.E. and M.B.




Publication History

Article published online:
22 October 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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