Is Pterional Craniotomy Adequate for Complete Excision of Olfactory Groove Meningioma

Objective: The aim is 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 from January 1990 to December 2012, data of clinical presentation, radiological features, surgical procedure, the outcome of surgery, and tumor recurrence were collected and analyzed.

Results: There were 40 patients of whom 18% were males, and 82% females; the median age was 44 years. The tumor was < 3 cm in 12%, 3 to 5 cm in 58%, and > 5 cm in 30% of patients. Results of patients operated through pterional approach (15 patients) were compared with those (25 patients) who had surgery through other approaches (bifrontal approach, supraorbital approach, and combined approaches).Total resection (Simpson I) was achieved in all the 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 was 1 to 14 years (mean 8 years). 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.