Microscope-Assisted Supraorbital Keyhole Craniotomy for the Resection of Large Olfactory Groove Meningiomas

Objective: Olfactory groove meningiomas (OGM) represent 8 to 13% of all intracranial meningiomas. These tumors are generally approached through open or endoscopic endonasal approaches.

To determine the postoperative outcomes of microscope-assisted supraorbital (eyebrow) keyhole approach (SKA) for the resection of large (>4 cm) OGM.

Methods: All patients who underwent microscope-assisted SKA by the senior author from January 2018 to September 2021 were prospectively identified and patient information and outcomes were collected.

Results: Four consecutive patients harboring WHO grade I OGM underwent resection through a supraorbital keyhole craniotomy with microscopic visualization. The mean age ± standard deviation (SD) was 65 years old ± 5.7 years. Symptoms at presentation included seizures (n = 1), anosmia or hyposmia (n = 2), visual changes (n = 1), aphasia (n = 1), abnormal gait (n = 1), and headaches (n = 1). The mean preoperative KPS was 75 (range: 30–100). The average preoperative tumor diameter was 4.71 cm (range: 4–7 cm). The average preoperative tumor volume ± SD was 24.8± 19.78 cm³ and the mean preoperative FLAIR volume was 50.9 ± 71.92 cm³. Gross total resection (GTR) was achieved in all cases. The mean length of stay was 4 ± 2.8 days, all patients were discharged home. The average postoperative KPS score was 97.5, without any postoperative complications or new neurological deficits. The mean length of follow-up was 66 days (range: 14–115 days). In two patients FLAIR volume disappeared on follow-up, the average time for FLAIR disappearance was of 107.5 ± 10.6 days. No patients had tumor recurrence upon follow-up.

Conclusion: Microscope-Assisted Supraorbital Keyhole craniotomy represents a safe and effective technique with high rates of GTR and minimal postoperative morbidity for large OGM.

Publikationsverlauf

Artikel online veröffentlicht:
15. Februar 2022