Surgical Experience in 33 Cases of Olfactory Groove Meningiomas

Abstract

Introduction: Meningiomas comprise approximately 15–20% of all intracranial tumors, and skull base meningiomas account for 25–30% of all meningiomas. Over the past two decades, skull base surgery has significantly improved. However, the rate of recurrence after these surgeries is disproportionally high at 40–50%. The purpose of this study was to examine a subgroup of skull base meningiomas (olfactory groove) that were treated in our institution to see if they behave differently and to determine if total and complete resection was achievable. Methods: Surgically resected olfactory groove meningiomas were reviewed from January 1997 to December 2007. Patient demographics, clinical signs and symptoms, tumor size and location, surgical approaches, and outcome data were gathered. Results: From 159 skull base meningiomas, 33 were categorized as olfactory groove meningiomas. Clinical findings included headaches, visual problems, anosmia, frontal lobe syndrome, and seizures. Surgical approaches included bifrontal + orbitotomy in most of the cases. Gross total resection was obtained, as defined by Simpson grade I or II, in 30 of the cases; subtotal resection, as defined by Simpson grade III or IV, was obtained in 3 cases. There were no deaths. Conclusions: Although the emphasis on modern skull base surgery has been to preserve neuronal function, tumor control through total resection can be achieved in olfactory groove meningiomas.