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J Neurol Surg A Cent Eur Neurosurg
DOI: 10.1055/a-2249-7710
Original Article

Anatomy and Microsurgical Relevance of the Outer Arachnoid Envelope around the Olfactory Bulb Based on Endoscopic Cadaveric Observations

Peter Kurucz
1   Department of Neurosurgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
2   Department of Neurosurgery, Katharinenhospital, Klinikum Stuttgart, Stuttgart, Germany
,
Oliver Ganslandt
2   Department of Neurosurgery, Katharinenhospital, Klinikum Stuttgart, Stuttgart, Germany
,
Michael Buchfelder
1   Department of Neurosurgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
,
Sasan Darius Adib
3   Department of Neurosurgery, University of Tuebingen, Tuebingen, Germany
,
Laszlo Barany
1   Department of Neurosurgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
4   Laboratory for Applied and Clinical Anatomy, Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
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Abstract

Background There is high risk of injury to the olfactory tract and olfactory bulb during surgery of the anterior cranial fossa. The goal of this study was to describe the outer arachnoid envelope around the olfactory bulb, which plays a significant role in approach-related injury of the nerve.

Methods A total of 20 fresh human cadaveric heads were examined. Five cadaveric heads were used to describe a gross overview of the topographic anatomy of the outer arachnoid cover of the olfactory bulb. In 15 cadaveric heads, endoscopic surgical approaches were performed to examine the in situ undisrupted anatomy of the outer arachnoid around the olfactory bulb. Four cadaveric heads were used for the lateral subfrontal approach, 5 heads for the medial subfrontal approach, 3 heads for the median subfrontal approach, and 3 heads for the anterior interhemispheric approach.

Results The outer arachnoid membrane of the frontal lobe attaches the olfactory bulb strongly to the above lying olfactory sulcus. Only the most rostral portion of the olfactory bulb became slightly detached from the frontal lobe. The outer arachnoid forms a decent protrusion around the tip of the olfactory bulbs. The fila olfactoria have their own outer arachnoid cover as a continuation of the same layer of the olfactory bulb. The effect of brain retraction and manipulation forces on the olfactory bulb and the role of the arachnoid membranes located here were visually analyzed and described in detail through the four different neurosurgical approaches we performed.

Conclusion The results of our observations provide important anatomical details for preserving the sense of smell during neurosurgical procedures.

Keywords

olfactory bulb - arachnoid membranes - endoscopic anatomy - microsurgical anatomy

Ethical Approval

Formal consent is not required due the nature of the study.




Publication History

Received: 10 October 2023

Accepted: 17 January 2024

Accepted Manuscript online:
19 January 2024

Article published online:
08 July 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Favre JJ, Chaffanjon P, Passagia JG, Chirossel JP. Blood supply of the olfactory nerve. Meningeal relationships and surgical relevance. Surg Radiol Anat 1995; 17 (02) 133-138 , 12–14
    CrossrefPubMedGoogle Scholar
  • 2 Boesveldt S, Parma V. The importance of the olfactory system in human well-being, through nutrition and social behavior. Cell Tissue Res 2021; 383 (01) 559-567
    CrossrefPubMedGoogle Scholar
  • 3 Bamimore MA, Marenco-Hillembrand L, Ravindran K. et al. Smell outcomes in olfactory groove meningioma resection through unilateral versus bilateral transcranial approaches: a systematic review and meta-analysis. World Neurosurg 2022; 160: 22-32
    CrossrefPubMedGoogle Scholar
  • 4 Ved R, Mo M, Hayhurst C. Olfactory outcomes after resection of tuberculum sella and planum sphenoidale meningiomas via a transcranial approach. J Neurol Surg B Skull Base 2021; 83 (03) 296-304
    PubMedGoogle Scholar
  • 5 Cardali S, Romano A, Angileri FF. et al. Microsurgical anatomic features of the olfactory nerve: relevance to olfaction preservation in the pterional approach. Neurosurgery 2005; 57 (1, Suppl): 17-21 , discussion 17–21
    PubMedGoogle Scholar
  • 6 Wang SS, Zheng HP, Zhang X, Zhang FH, Jing JJ, Wang RM. Microanatomy and surgical relevance of the olfactory cistern. Microsurgery 2008; 28 (01) 65-70
    CrossrefPubMedGoogle Scholar
  • 7 Cömert A, Uğur HÇ, Kahiloğullar G, Cömert E, Elhan A, Tekdemir I. Microsurgical anatomy for intraoperative preservation of the olfactory bulb and tract. J Craniofac Surg 2011; 22 (03) 1080-1082
    CrossrefPubMedGoogle Scholar
  • 8 Perneczky A, Reisch R. Keyhole Approaches in Neurosurgery. New York, NY: Springer Wien; 2008
    Google Scholar
  • 9 Yasargil MG. Microneurosurgery. Vol IIIA.. New York, NY: Thieme; 1987
    Google Scholar
  • 10 Vinas FC, Dujovny M, Fandino R, Chavez V. Microsurgical anatomy of the infratentorial trabecular membranes and subarachnoid cisterns. Neurol Res 1996; 18 (02) 117-125
    CrossrefPubMedGoogle Scholar
  • 11 Vinas FC, Dujovny M, Fandino R, Chavez V. Microsurgical anatomy of the arachnoidal trabecular membranes and cisterns at the level of the tentorium. Neurol Res 1996; 18 (04) 305-312
    CrossrefPubMedGoogle Scholar
  • 12 Vinas FC, Fandino R, Dujovny M, Chavez V. Microsurgical anatomy of the supratentorial arachnoidal trabecular membranes and cisterns. Neurol Res 1994; 16 (06) 417-424
    CrossrefPubMedGoogle Scholar
  • 13 Vinas FC, Panigrahi M. Microsurgical anatomy of the Liliequist's membrane and surrounding neurovascular territories. Minim Invasive Neurosurg 2001; 44 (02) 104-109
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Lü J, Zhu X. Microsurgical anatomy of the interpeduncular cistern and related arachnoid membranes. J Neurosurg 2005; 103 (02) 337-341
    CrossrefPubMedGoogle Scholar
  • 15 Lü J, Zhu XL. Characteristics of distribution and configuration of intracranial arachnoid membranes. Surg Radiol Anat 2005; 27 (06) 472-481
    CrossrefPubMedGoogle Scholar
  • 16 Lü J, Zhu XL. Cranial arachnoid membranes: some aspects of microsurgical anatomy. Clin Anat 2007; 20 (05) 502-511
    CrossrefPubMedGoogle Scholar
  • 17 Martins C, Yasuda A, Campero A, Rhoton Jr AL. Microsurgical anatomy of the oculomotor cistern. Neurosurgery 2006; 58 (4, Suppl 2): ONS-220-ONS-227 , discussion ONS-227–ONS-228
    PubMedGoogle Scholar
  • 18 Inoue K, Seker A, Osawa S, Alencastro LF, Matsushima T, Rhoton Jr AL. Microsurgical and endoscopic anatomy of the supratentorial arachnoidal membranes and cisterns. Neurosurgery 2009; 65 (04) 644-664 , discussion 665
    CrossrefPubMedGoogle Scholar
  • 19 Song-tao Q, Xi-an Z, Hao L, Jun F, Jun P, Yun-tao L. The arachnoid sleeve enveloping the pituitary stalk: anatomical and histologic study. Neurosurgery 2010; 66 (03) 585-589
    CrossrefPubMedGoogle Scholar
  • 20 Song-tao Q, Xi-an Z, Jun F, Guang-long H, Jun P, Bing-hui Q. Anatomical study of the arachnoid envelope over the pineal region. Operative Neurosurgery 2011; 68: ons7-ons15
    CrossrefPubMedGoogle Scholar
  • 21 Zhang XA, Qi ST, Huang GL, Long H, Fan J, Peng JX. Anatomical and histological study of Liliequist's membrane: with emphasis on its nature and lateral attachments. Childs Nerv Syst 2012; 28 (01) 65-72
    CrossrefPubMedGoogle Scholar
  • 22 Adeeb N, Deep A, Griessenauer CJ. et al. The intracranial arachnoid mater : a comprehensive review of its history, anatomy, imaging, and pathology. Childs Nerv Syst 2013; 29 (01) 17-33
    CrossrefPubMedGoogle Scholar
  • 23 Kurucz P, Ganslandt O, Buchfelder M, Barany L. Microsurgical anatomy and pathoanatomy of the outer arachnoid membranes in the cerebellopontine angle: cadaveric and intraoperative observations. Acta Neurochir (Wien) 2023; 165 (07) 1791-1805
    PubMedGoogle Scholar
  • 24 Kurucz P, Baksa G, Patonay L, Hopf NJ. Endoscopic anatomical study of the arachnoid architecture on the base of the skull. Part II: level of the tentorium, posterior fossa and the craniovertebral junction. Innov Neurosurg 2013; 1 (02) 91-108
    CrossrefPubMedGoogle Scholar
  • 25 Lü J. Arachnoid membrane: the first and probably the last piece of the roadmap. Surg Radiol Anat 2015; 37 (02) 127-138
    CrossrefPubMedGoogle Scholar
  • 26 Kurucz P, Ganslandt O. Letter to the editor regarding “Anatomic dissection of arachnoid membranes encircling the pituitary stalk on fresh non-formalin-fixed specimens: anatomoradiologic correlations and clinical applications in craniopharyngioma surgery.”. World Neurosurg 2018; 109: 505-506
    CrossrefPubMedGoogle Scholar
  • 27 Cheng CM, Noguchi A, Dogan A. et al. Quantitative verification of the keyhole concept: a comparison of area of exposure in the parasellar region via supraorbital keyhole, frontotemporal pterional, and supraorbital approaches. J Neurosurg 2013; 118 (02) 264-269
    CrossrefPubMedGoogle Scholar
  • 28 Lee JS, Scerrati A, Zhang J, Ammirati M. Quantitative analysis of surgical exposure and surgical freedom to the anterosuperior pons: comparison of pterional transtentorial, orbitozygomatic, and anterior petrosal approaches. Neurosurg Rev 2016; 39 (04) 599-605
    CrossrefPubMedGoogle Scholar
  • 29 Reisch R, Perneczky A. Ten-year experience with the supraorbital subfrontal approach through an eyebrow skin incision. Neurosurgery 2005; 57 (4, Suppl): 242-255 , discussion 242–255
    PubMedGoogle Scholar
  • 30 Hendrix P, Fischer G, Krug J. et al. Olfactory dysfunction in patients undergoing supraorbital keyhole craniotomy for clipping of unruptured aneurysms. Clin Anat 2020; 33 (02) 316-323
    CrossrefPubMedGoogle Scholar
  • 31 Ng AF, Quintero RB, Muftah Lahirish IA, Holanda V, Neto MR, De Oliveira E. Microsurgical anatomy review of bifrontal limited transbasal approach: quantitative and anatomy study. World Neurosurg 2020; 141: e1-e8
    CrossrefPubMedGoogle Scholar
  • 32 Matano F, Murai Y, Mizunari T. et al. Olfactory preservation during anterior interhemispheric approach for anterior skull base lesions: technical note. Neurosurg Rev 2016; 39 (01) 63-68 , discussion 69
    CrossrefPubMedGoogle Scholar