Introduction: surgery of anterior skull base meningiomas is technically demanding. We report our experience with microsurgical dissection over a period of 14 years.
Methods: from our prospectively gained meningiomas’ database we analyzed retrospectively all patients operated on olfactory groove meningioma between the years 1997-2010. Special attention was given to mortality/morbidity and their correlation with tumor size and perifocal edema.
Results: 46 patients were included from 774 patients operated on meningioma (5,9%). Mean age was 60 and male/female ratio was 10/36. Five (10,8%) patients died due to operative complications. Four patients worsened due to the operation. Nevertheless the rest of the patients (37) retained or improved their good clinical condition (measured both on KPS as GOS). GTR (Simpson I-III) was reached in 41 patients (89%). All, except of 3 patients with grade 2, had grade 1 meningioma (93%). Five patients showed recurrence during the follow-up period (4 of them with Simpson grade 4 resection grade). Tumor size < 4cm, 4cm-6cm and >6cm was noted in 9, 15 and 22 patients respectively. Edema was absent, moderate or massive in 11, 25 and 10 patients respectively. Mortality showed no correlation with resection grade, tumor size and extent of edema (p=0.55, p=0.73and p=0.55 respectively). Morbidity as well showed no correlation with resection grade, tumor size and extent of edema (p= 0.84, p=0.88 andp= 0.29 respectively).
Conclusions: olfactory groove meningiomas are not easy to handle but allows mostly GTR with good clinical outcome to be achieved. Nevertheless our experience shows that mortality is still present. Tumor size, edema and resection grade did not correlate with mortality.
Patient Care: Physicians would gain more insight into management of olfactory groove menigiomas, their operative risk and operative planning.
Learning Objectives: Participants should be able to discuss the operative management of olfactory groove meningiomas, their operative risk and operative planning.