Endoscopic Endonasal Resection of a Groove Meningioma with Olfactory Preservation

Background: There are few cases in the literature demonstrating resection of olfactory groove meningiomas with olfactory preservation. Although the standard treatment for olfactory groove meningiomas uses traditional transcranial routes, the endoscopic endonasal approach (EEA) has been used with increased frequency. One of the main benefits of the EEA is the lack of frontal lobe retraction required to access the lesion. Preservation of olfaction can be challenging using either approach, but especially so for the EEA, due not only to the location of the olfactory nerves in relation to the tumor, but also to the transgression of olfactory epithelium during the approach.

Technique and Case Illustration: A case of a large anterior fossa meningioma with olfactory function preservation is presented. The technique used is described.

Conclusion: The EEA is one option skull base surgeons have for accessing large anterior cranial fossa meningiomas. In our experience, the ability to preserve olfaction is dependent on both the size and location of the tumor. Chances of maintaining olfaction are greatest when at least one nerve and a portion of corresponding olfactory epithelium, usually at the anterior-most extent of the dissection, can be preserved.