J Neurol Surg B
DOI: 10.1055/s-0039-1688794
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Smell Preservation following Unilateral Endoscopic Transnasal Approach to Resection of Olfactory Groove Meningioma: A Multi-institutional Experience

1  Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia
,
2  Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, United States
,
Raquel Alvarado
1  Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia
,
Nithin D. Adappa
2  Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, United States
,
Benjamin P. Jonker
1  Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia
,
John Y. K. Lee
3  Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, United States
,
James N. Palmer
2  Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, United States
,
Mark Winder
1  Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia
,
Richard J. Harvey
1  Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of New South Wales, Sydney, New South Wales, Australia
4  Department of Otolaryngology-Head & Neck Surgery, Macquarie University, Sydney, New South Wales, Australia
› Author Affiliations
Further Information

Publication History

17 December 2018

23 March 2019

Publication Date:
28 May 2019 (online)

Abstract

Introduction Olfactory groove meningiomas (OGMs) are often associated with loss of smell following resection. Loss of smell has a measurable impact on quality of life. Smell preservation has been previously described in open approaches for early stage or unilateral OGMs. Evidence of smell preservation in endoscopic approaches is lacking.

Design A multi-institutional retrospective review was performed on consecutive patients who underwent unilateral endoscopic endonasal resection of OGM. A gross total resection was achieved with preservation of the contralateral olfactory cleft and bulb. Olfactory function was assessed with a six-point olfactory symptom score and the Sniffin' Sticks 12-item smell identification test (SS-12). Contralateral olfactory bulb volume was measured on postoperative magnetic resonance imaging.

Results Four patients (age 42.0 ± 7.5, 75% female) were assessed. Olfactory function was assessed at 21.8 ± 5.6 months following surgery. All patients reported some degree of smell preservation (75% described a slight/mild impairment in smell or better). Olfactory identification was preserved with an SS-12 score of 9 ± 1.4 (anosmia defined as ≤6). The olfactory bulb volume was calculated to be 47.4 ± 15.9 mm3 (normal >40 mm3).

Conclusion Smell preservation is possible following unilateral endoscopic endonasal resection of carefully selected OGM.