Olfaction Preservation in Olfactory Grove Meningiomas Operated with Endonasal Endoscopical Technique. A Proposal of a New Surgical Corridor Trough a Cadaveric Study

Introduction: It's well known that before and after surgery, olfactory grove meningiomas have a great impact in olfaction and despite not be considered as a primary sensory function, its impairment significantly affects the quality of life. Endonasal Endoscopic surgery for these kind of pathology between multiple advantages, reduces brain manipulation, avoids skin scars and reduces the recovery time, but in comparison to the open surgery the preservation of olfactory function is still a matter of debate. In this study we propose an endoscopic endonasal surgical access with the aim to spare the olfactory mucosa and nerve, trying not to damage the fimbria and the vessels that irrigate this structures

Methods: Through anatomical dissections we manage to study the feasibility of doing this access sparing part of the nasal septum and the cribriform plate making corridors laterally removing Fovea Ethmoidalis, posterior in the Planum Sphenoidale and a Draf III anterior to the cribriform plate also removing the Crista Galli. The bone is only preserved around the fimbriae, which are retracted laterally.

Conclusion: We were able to perform the dissection making effective surgical corridors for dissecting a tumor but further investigation needs to be done to define the limitations of this surgical access and function outcomes.