Giant Olfactory Groove Meningiomas: A Case Series Demonstrating the Surgical Management and Functional Outcomes.

Asian journal of neurosurgery Pub Date : 2024-10-22 eCollection Date: 2025-03-01 DOI:10.1055/s-0044-1791840
Ashraf Elbadry, Azza Abdelazeez, Mohamed Badran
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Abstract

Objective  Giant olfactory groove meningiomas (OGMs) present technical challenges in their management, especially when their size and location complicate the evaluation and planning process, making complete removal difficult. This study provides a comprehensive analysis of the surgical approaches and outcomes encountered in the management of giant OGMs at a single institution. Materials and Methods  This retrospective study evaluated surgical and functional outcomes in 71 patients diagnosed with giant OGMs larger than 6 cm. Tumors were excised using microsurgical resection via the bifrontal, pterional, or combined pterional and unifrontal approaches. Results  The study comprised 48 females (67.6%) and 23 males (32.4%), with a mean age of 54.1 years. The most common pathological type was meningothelial meningioma (45%). The bifrontal approach was the most frequently used ( n  = 47, 66.2%) and resulted in Simpson grade I or II resection in 41 patients (87.2%). The combined pterional and unifrontal approaches were used in 16 patients (22.5%), achieving Simpson grade I or II resection in 12 (75%). The pterional approach was the least commonly used ( n  = 8), with Simpson grade I or II resection achieved in 50% of these patients. Postoperatively, visual acuity and cognitive function improved during follow-up. Postoperative complications were frequently observed after the bifrontal approach. Three patients (4.2%) died. Conclusion  The bifrontal approach resulted in better resection of giant OGMs than other approaches but was associated with more complications. The combined pterional and unifrontal approach was superior to the pterional approach in terms of OGM resection, with no differences in complication rates. Significant postoperative improvements in functional outcomes, including visual acuity and cognitive function, were observed.

巨型嗅沟脑膜瘤:展示手术治疗和功能结果的病例系列。
目的巨大嗅沟脑膜瘤(OGMs)的治疗面临技术挑战,特别是其大小和位置使评估和计划过程复杂化,使完全切除变得困难。本研究提供了一个全面的分析,在单一机构的巨大ogm的管理遇到的手术方法和结果。材料和方法本回顾性研究评估了71例诊断为大于6 cm的巨大ogm患者的手术和功能结局。肿瘤通过双额路、翼面路或翼面和单面联合入路显微外科切除。结果女性48例(67.6%),男性23例(32.4%),平均年龄54.1岁。最常见的病理类型为脑膜上皮性脑膜瘤(45%)。双额路入路是最常用的(n = 47, 66.2%), 41例患者(87.2%)获得Simpson I级或II级切除术。16例(22.5%)患者采用了翼位和单面联合入路,12例(75%)患者实现了Simpson I级或II级切除术。翼点入路是最不常用的(n = 8),其中50%的患者实现了Simpson I级或II级切除术。术后随访,视力及认知功能均有改善。双额路入路术后并发症较多。3例(4.2%)死亡。结论双额入路切除巨大骨肉瘤的效果优于其他入路,但并发症较多。在OGM切除方面,翼位和单面联合入路优于翼位入路,并发症发生率无差异。术后功能结果显著改善,包括视力和认知功能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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