Preservation of Olfaction in Olfactory Groove Meningiomas with Stereotactic Radiosurgery

Abstract

Objective and Importance: Anosmia is a frequent complication of surgical treatment of olfactory groove meningiomas (OGMs). The loss of olfaction can significantly impact on patient quality of life. We present 3 patients with incidentally discovered small OGMs who were treated with stereotactic radiosurgery (SRS). All patients have had tumor control and have not suffered from olfactory loss. This is the first study to elaborate on the safety of SRS in relation to the first cranial nerve. Clinical Case Presentation: Three women, aged 46, 62 and 52 years, presented with incidentally discovered OGMs. They were all asymptomatic from these tumors and had intact olfaction. Intervention: Two patients received single session SRS, 1 with 2,000 cGy to the 85th percentile line, and the other 1,500 cGy to the 85th percentile line. The third patient chose hypofractionated SRS because she was an employee of the hospital and did not wish her colleagues to see her with a frame. She received 2,600 cGy in five daily fractions. All 3 patients have had tumor control with no complications and remain symptom-free with intact olfaction. Conclusion: SRS provides an excellent treatment alternative for a select group of patients with OGMs who wish to maintain their sense of smell.