Is Pterional Craniotomy Adequate for Complete Excision of Olfactory Groove Meningioma

Objective: This study aims to study the feasibility of complete surgical excision of olfactory groove meningioma (OGM) through pterional craniotomy (PC). Patients and Methods: We reviewed all patients with OGM who had surgical excision through PC at KKUH during the period Januray, 1990 to December, 2012, data of clinical presentation, radiological features, surgical procedure, outcome of surgery, and tumor recurrence were collected and analyzed. Results: There were 40 patients, 18% males and 82% females; the median age was 44 years. The tumor size was < 3 cm in 12%, 3 to 5 cm in 58%, and > 5 cm in 30% of patients. Pterional approach was used in all patients. The author excluded patients with OGM who had surgery through other approaches (bifrontal approach, supraorbital approach, and combined approaches). Total resection (Simpson grade I) was achieved in all patients. Postoperative complications included CSF collection, superficial wound infection in one patient, postoperative seizures in two patients, EDH in one patient, and DVT in one patient. Follow-up period ranged from 6 months to 10 years (mean, 43 months). Tumor recurrence was seen in 10% of patients. Conclusion: Pterional craniotomy is adequate for complete excision of OGM, it allows minimal brain exposure and manipulation with minimal postoperative brain swelling, complete removal with excellent neurosurgical outcome, minimal permanent morbidity and low recurrence rates.