J Neurol Surg B Skull Base 2021; 82(S 02): S65-S270
DOI: 10.1055/s-0041-1725494
Presentation Abstracts
Poster Abstracts

Eyebrow Supraorbital Keyhole Craniotomy for Olfactory Groove Meningiomas with Endoscope Assistance: Case Series and Systematic Review of Extent of Resection, Quantification of Postoperative Frontal Lobe Injury, Anosmia, and Recurrence

Brett E. Youngerman
1   Columbia University Medical Center, Columbia, United States
,
Lior Shtayer
2   Weill Cornell Medicine, New York, New York, United States
,
Mina M. Gerges
3   Ain Shams University, Egypt
,
Alexandra G. Larsen
2   Weill Cornell Medicine, New York, New York, United States
,
Hilarie C. Tomasiewicz
4   Emory University, Atlanta, Georgia, United States
,
Theodore H. Schwartz
2   Weill Cornell Medicine, New York, New York, United States
› Author Affiliations
› Further Information
 

Background: Olfactory groove meningiomas (OGMs) are commonly treated with open craniotomy. Endonasal approaches have also been described.

Objective: This study was aimed to present clinical and radiographic outcomes for the minimally invasive eyebrow incision supraorbital keyhole approach with endoscopic assistance for OGMs.

Methods: We performed a retrospective single-center cohort study and a systematic literature review.

Results: Fifteen patients were identified, all with grade-I meningiomas. Radiographic GTR of enhancing tumor was achieved in all patients. Mean frontal lobe FLAIR volume decreased from 11.1 ± 18.3 cm3 preoperatively to 9.9 ± 11.4 cm3 immediate postoperatively and there was minimal new restricted diffusion (3.2 ± 2.2 cm3; max 7.5 cm3). Median length of stay was 3 days (range: 2–8 days). Vision was improved in four (80%) and stable in one (20%) of five patients with a preoperative deficit. New postoperative anosmia occurred in 3 (23%) of 13 patients with any preoperative olfaction. All patients were satisfied with their cosmetic result at 3 months. After a median follow-up of 32.2 months, there were two (13.3%) asymptomatic radiographic recurrences, one treated with radiosurgery, and the other with endoscopic endonasal approach (EEA). No patients required further craniotomy. Systematic review revealed the present series to be the largest to date reporting disaggregated outcomes for the eyebrow approach to OGM.

Conclusion: The eyebrow incision supraorbital keyhole craniotomy with endoscopic assistance is a safe and effective approach to OGM with tumor control rates similar to more invasive open approaches and better than the endonasal approach. Rates of frontal lobe injury, CSF leak, and anosmia are comparatively low.



Publication History

Article published online:
12 February 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany