Olfactory Groove Meningiomas and the Association with Postoperative Weight Loss

Background: Olfactory groove meningiomas (OGM) comprise 18–55% of intracranial meningiomas and more than half of patients with OGMs present with hyposmia or anosmia. Aberrations in olfaction significantly affects patients’ quality of life. Postoperative weight loss after meningioma resection has been reported at around 1% based on a national database study, however, there are no sub-analyses based on intracranial tumor location. Given the relationship to olfaction and gustation, we aim to evaluate the relationship of OGM resection and postoperative changes in BMI.

Methods: We retrospectively reviewed adult patients with primary resection of meningioma between 2017 and 2023 at a single institution in this IRB-approved study. Exclusion criteria were patients with neurofibromatosis type 2, previous brain surgery, pregnancy, intraosseous location, and lack of follow-up data. Data collected included age, sex, race, tumor location, tumor grade, tumor number, tumor volume, extent of resection, surgical approach, primary surgeon, length of inpatient stay, complications, readmission, reoperation, pre- and postoperative radiation therapy, diabetes diagnosis, inpatient diabetes management, preoperative BMI (preBMI) and postoperative BMI at 3–6-month follow-up (poBMI). Percent BMI change (pcBMI) was calculated by (poBMI–preBMI/preBMI *100%). IBM SPSS Statistics (Version 27) was used for descriptive statistics and stepwise multiple linear regression.

Results: Ninety-eight patients of 171 (26 males, 72 females) met inclusion criteria with a mean age of 57.15 ± 13.65 years. A total of 40 meningiomas were located in the anterior cranial fossa, with 18 in the olfactory groove. Fifty-eight tumors were in alternative locations including convexity, parafalcine, middle fossa, and intraventricular. Mean preBMI was 31.30 ± 7.41 kg/m² and mean pcBMI was −1.87 ± 6.29%. In OGM, a postoperative decrease in BMI was observed in 72.22% (13/18) of patients (8 females; mean age 55.79 ± 13.59), and an increase in BMI in 27.78% (5/18) patients (3 females; mean age 53.54 ± 19.66). Preoperative loss of olfaction was reported in 43.75% (7/16) patients and postoperative loss of olfaction was reported in 53.33% (8/15) patients with OGM. Univariate analysis found olfactory groove locations and preBMI significant and were included in the regression. Multiple linear regression was used to test if olfactory groove location and preBMI significantly predicted negative pcBMI. The fitted regression model was: pcBMI = 4.090–4.528*(olfactory groove. - .164*(preBMI). The overall regression model was statistically significant (R2 = 0.134), F(2, 95) = 7.342, p = 0.001. Both increased preBMI (β = −0.164, p = 0.049) and olfactory groove location (β = −4.528, p = 0.005) significantly predicted negative pcBMI.

Conclusion: The results indicate that increased preBMI and olfactory groove location are predictors of decreased BMI on short-term follow-up. The high rates of olfactory disturbance in OGM meningiomas could play a role in the increased postoperative weight loss. Future directions include evaluation of impact of olfactory disturbance on preBMI, poBMI, and pcBMI in patients with meningioma and further analysis at 1-year follow-up.

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Artikel online veröffentlicht:
05. Februar 2024