Lateral supraorbital approach for microsurgical resection of olfactory groove meningiomas

Abstract

Objective To investigate the safety and efficacy of the application of lateral supraorbital (LSO) approach for microsurgical resection of olfactory groove meningiomas. Methods Between January 2013 and December 2016, 20 patients with olfactory groove meningiomas underwent surgery through LSO approach at Department of Neurosurgery, the Second Affiliated Hospital of Zhejiang University School of Medicine. Their clinical data, surgical treatment and outcomes were analyzed retrospectively. Neuroradiological findings, improvement of symptoms and some relevant evaluation scales were used to assess the efficacy and safety of LSO for resection of olfactory groove meningiomas. Results Six patients had Simpson grade Ⅰ resection, 12 had Simpson grade Ⅱ grade resection and 2 had Simpson grade Ⅳ resection. The mean operation time was 204.8±77.4 min and the mean intraoperative blood loss was 192.5±109.2 ml. Four patients developed fever post operation, 1 had psychiatric symptoms, 1 had disturbance of consciousness, 1 had cerebral edema, and 1 developed seizure. No incision infection or cerebrospinal fluid rhinorrhea occurred. Post surgery, 2 out of 8 patients with preoperative impairment of olfactory function obtained symptomatic improvement. Among the 4 patients with vision impairment, 2 achieved improvement, 1 remained the same and 1 reported aggravation. During the follow-up of 19 patients lasting 3-40 months with an average of 16.4±9.7 months, favorable outcomes were reported in 16 cases, severe disability in 1 and tumor recurrence in 2. There was no death. Conclusion Microsurgery through LSO approach demonstrates advantages in resection of olfactory groove meningiomas including shorter operative duration, less invasiveness, and low morbidity and mortality, which is thus worthy of recommendation. Key words: Meningioma; Microsurgery; Lateral supraorbital approach; Treatment outcome