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J Neurol Surg B Skull Base 2017; 78(03): 245-250
DOI: 10.1055/s-0036-1597925
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Phantosmia and Dysgeusia following Endoscopic Transcribriform Approaches to Olfactory Groove Meningiomas

Andrew S. Venteicher   *
1   Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Jay I. Kumar   *
1   Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Emma A. Murphy
1   Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Stacey T. Gray
2   Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
,
Eric H. Holbrook
2   Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
,
William T. Curry
1   Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
› Author Affiliations
Further Information

Publication History

20 August 2016

29 November 2016

Publication Date:
18 January 2017 (online)

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Abstract

The endoscopic, endonasal transcribriform approach (EETA) is an important technique used to directly access the anterior skull base and is increasingly being used in the management of olfactory groove meningiomas (OGMs). As this approach requires removal of the cribriform plate and olfactory epithelium en route to the tumor, patients are anosmic postoperatively. Here, we report the development of phantosmia and dysgeusia in two patients who underwent EETAs for OGMs, which has not yet been reported in the literature. We hypothesize that phantosmia and dysgeusia may result from aberrant neuronal signals or misinterpretation centrally from the remaining distal portions of the olfactory and taste pathways. Since EETAs are newer than traditional open craniotomy-based techniques, reporting these outcomes will be important to appropriately counsel patients preoperatively.

Keywords

olfactory groove meningioma - transcribriform - phantosmia - dysgeusia - anterior skull base

* Co-first authors.


 

  • References

  • 1 Bakay L. Olfactory meningiomas. The missed diagnosis. JAMA 1984; 251 (01) 53-55
    CrossrefPubMedGoogle Scholar
  • 2 Hentschel SJ, DeMonte F. Olfactory groove meningiomas. Neurosurg Focus 2003; 14 (06) e4
    PubMedGoogle Scholar
  • 3 Zygourakis CC, Sughrue ME, Benet A, Parsa AT, Berger MS, McDermott MW. Management of planum/olfactory meningiomas: predicting symptoms and postoperative complications. World Neurosurg 2014; 82 (06) 1216-1223
    CrossrefPubMedGoogle Scholar
  • 4 Nakamura M, Struck M, Roser F, Vorkapic P, Samii M. Olfactory groove meningiomas: clinical outcome and recurrence rates after tumor removal through the frontolateral and bifrontal approach. Neurosurgery 2008; 62 (06) , (suppl 3) 1224-1232
    CrossrefPubMedGoogle Scholar
  • 5 Bitter AD, Stavrinou LC, Ntoulias G. , et al. The Role of the pterional approach in the surgical treatment of olfactory groove meningiomas: a 20-year experience. J Neurol Surg B Skull Base 2013; 74 (02) 97-102
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Pallini R, Fernandez E, Lauretti L. , et al. Olfactory groove meningioma: report of 99 cases surgically treated at the Catholic University School of Medicine, Rome. World Neurosurg 2015; 83 (02) 219-31.e1 , 3
    CrossrefPubMedGoogle Scholar
  • 7 Liu JK, Hattar E, Eloy JA. Endoscopic endonasal approach for olfactory groove meningiomas: operative technique and nuances. Neurosurg Clin N Am 2015; 26 (03) 377-388
    CrossrefPubMedGoogle Scholar
  • 8 Greenfield JP, Anand VK, Kacker A. , et al. Endoscopic endonasal transethmoidal transcribriform transfovea ethmoidalis approach to the anterior cranial fossa and skull base. Neurosurgery 2010; 66 (05) 883-892 , discussion 892
    CrossrefPubMedGoogle Scholar
  • 9 Gardner PA, Kassam AB, Thomas A. , et al. Endoscopic endonasal resection of anterior cranial base meningiomas. Neurosurgery 2008; 63 (01) 36-52 , discussion 52–54
    CrossrefPubMedGoogle Scholar
  • 10 Komotar RJ, Starke RM, Raper DM, Anand VK, Schwartz TH. Endoscopic endonasal versus open transcranial resection of anterior midline skull base meningiomas. World Neurosurg 2012; 77 (5-6): 713-724
    CrossrefPubMedGoogle Scholar
  • 11 Khan OH, Anand VK, Schwartz TH. Endoscopic endonasal resection of skull base meningiomas: the significance of a “cortical cuff” and brain edema compared with careful case selection and surgical experience in predicting morbidity and extent of resection. Neurosurg Focus 2014; 37 (04) E7
    PubMedGoogle Scholar
  • 12 Estrem SA, Renner G. Disorders of smell and taste. Otolaryngol Clin North Am 1987; 20 (01) 133-147
    PubMedGoogle Scholar
  • 13 Davidson TM, Jalowayski A, Murphy C, Jacobs RD. Evaluation and treatment of smell dysfunction. West J Med 1987; 146 (04) 434-438
    PubMedGoogle Scholar
  • 14 Jang WY, Jung S, Jung TY, Moon KS, Kim IY. Preservation of olfaction in surgery of olfactory groove meningiomas. Clin Neurol Neurosurg 2013; 115 (08) 1288-1292
    CrossrefPubMedGoogle Scholar
  • 15 Graffeo CS, Dietrich AR, Grobelny B. , et al. A panoramic view of the skull base: systematic review of open and endoscopic endonasal approaches to four tumors. Pituitary 2014; 17 (04) 349-356
    CrossrefPubMedGoogle Scholar
  • 16 Hadley K, Orlandi RR, Fong KJ. Basic anatomy and physiology of olfaction and taste. Otolaryngol Clin North Am 2004; 37 (06) 1115-1126
    CrossrefPubMedGoogle Scholar
  • 17 Feng P, Huang L, Wang H. Taste bud homeostasis in health, disease, and aging. Chem Senses 2014; 39 (01) 3-16
    CrossrefPubMedGoogle Scholar
  • 18 Deems DA, Doty RL, Settle RG. , et al. Smell and taste disorders, a study of 750 patients from the University of Pennsylvania Smell and Taste Center. Arch Otolaryngol Head Neck Surg 1991; 117 (05) 519-528
    CrossrefPubMedGoogle Scholar
  • 19 Bushdid C, Magnasco MO, Vosshall LB, Keller A. Humans can discriminate more than 1 trillion olfactory stimuli. Science 2014; 343 (6177): 1370-1372
    CrossrefPubMedGoogle Scholar
  • 20 Hasan KS, Reddy SS, Barsony N. Taste perception in kallmann syndrome, a model of congenital anosmia. Endocr Pract 2007; 13 (07) 716-720
    CrossrefPubMedGoogle Scholar
  • 21 Hong SC, Holbrook EH, Leopold DA, Hummel T. Distorted olfactory perception: a systematic review. Acta Otolaryngol 2012; 132 (Suppl 1): S27-S31
    CrossrefPubMedGoogle Scholar
  • 22 Miwa T, Furukawa M, Tsukatani T, Costanzo RM, DiNardo LJ, Reiter ER. Impact of olfactory impairment on quality of life and disability. Arch Otolaryngol Head Neck Surg 2001; 127 (05) 497-503
    CrossrefPubMedGoogle Scholar
  • 23 Croy I, Nordin S, Hummel T. Olfactory disorders and quality of life--an updated review. Chem Senses 2014; 39 (03) 185-194
    CrossrefPubMedGoogle Scholar
  • 24 Henkin RI, Levy LM, Fordyce A. Taste and smell function in chronic disease: a review of clinical and biochemical evaluations of taste and smell dysfunction in over 5000 patients at The Taste and Smell Clinic in Washington, DC. Am J Otolaryngol 2013; 34 (05) 477-489
    CrossrefPubMedGoogle Scholar
  • 25 Pence TS, Reiter ER, DiNardo LJ, Costanzo RM. Risk factors for hazardous events in olfactory-impaired patients. JAMA Otolaryngol Head Neck Surg 2014; 140 (10) 951-955
    CrossrefPubMedGoogle Scholar
  • 26 Henkin RI, Hoye RC. Hyposmia secondary to excision of the olfactory epithelium. The definition of primary and accessory areas of olfaction. Life Sci 1966; 5 (04) 331-341
    CrossrefPubMedGoogle Scholar
  • 27 Hoye RC, Ketcham AS, Henkin RI. Hyposmia after paranasal sinus exenteration of laryngectomy. Am J Surg 1970; 120 (04) 485-491
    CrossrefPubMedGoogle Scholar
  • 28 Henkin RI, Levy LM, Lin CS. Taste and smell phantoms revealed by brain functional MRI (fMRI). J Comput Assist Tomogr 2000; 24 (01) 106-123
    CrossrefPubMedGoogle Scholar
  • 29 Levy LM, Henkin RI. Physiologically initiated and inhibited phantosmia: cyclic unirhinal, episodic, recurrent phantosmia revealed by brain fMRI. J Comput Assist Tomogr 2000; 24 (04) 501-520
    CrossrefPubMedGoogle Scholar
  • 30 Henkin RI, Potolicchio SJ, Levy LM. Olfactory hallucinations without clinical motor activity: a comparison of unirhinal with birhinal phantosmia. Brain Sci 2013; 3 (04) 1483-1553
    CrossrefPubMedGoogle Scholar
  • 31 Levy LM, Henkin RI. Brain gamma-aminobutyric acid levels are decreased in patients with phantageusia and phantosmia demonstrated by magnetic resonance spectroscopy. J Comput Assist Tomogr 2004; 28 (06) 721-727
    CrossrefPubMedGoogle Scholar
  • 32 Heckmann SM, Hujoel P, Habiger S. , et al. Zinc gluconate in the treatment of dysgeusia--a randomized clinical trial. J Dent Res 2005; 84 (01) 35-38
    CrossrefPubMedGoogle Scholar
  • 33 Deems DA, Yen DM, Kreshak A, Doty RL. Spontaneous resolution of dysgeusia. Arch Otolaryngol Head Neck Surg 1996; 122 (09) 961-963
    CrossrefPubMedGoogle Scholar
  • 34 Makler V, Litofsky NS. Successful treatment of dysgeusia after middle-ear surgery with amitriptyline: case report. Am J Otolaryngol 2015; 36 (03) 456-459
    CrossrefPubMedGoogle Scholar
  • 35 Leopold DA, Schwob JE, Youngentob SL, Hornung DE, Wright HN, Mozell MM. Successful treatment of phantosmia with preservation of olfaction. Arch Otolaryngol Head Neck Surg 1991; 117 (12) 1402-1406
    CrossrefPubMedGoogle Scholar
  • 36 Leopold DA, Loehrl TA, Schwob JE. Long-term follow-up of surgically treated phantosmia. Arch Otolaryngol Head Neck Surg 2002; 128 (06) 642-647
    CrossrefPubMedGoogle Scholar
  • 37 Barker KE, Batstone MD, Savage NW. Comparison of treatment modalities in burning mouth syndrome. Aust Dent J 2009; 54 (04) 300-305 , quiz
    CrossrefPubMedGoogle Scholar
  • 38 Henkin RI, Potolicchio Jr SJ, Levy LM. Improvement in smell and taste dysfunction after repetitive transcranial magnetic stimulation. Am J Otolaryngol 2011; 32 (01) 38-46
    CrossrefPubMedGoogle Scholar
  • 39 Silas J, Atif MA, Doty RL. Transcranial magnetic stimulation: a treatment for smell and taste dysfunction. Am J Otolaryngol 2011; 32 (02) 177 , author reply 178–180
    CrossrefPubMedGoogle Scholar