B, unilateralfrontal craniotomy with subfrontal approach. Pathologic examination of the tissue confirmed the diagnosis of meningioma. Most common symptoms are anosmia, headaches, and visual disturbances, but a range of manifestations, both neurologic and psychiatric, has been described in a significant number of patients. Nine patients with giant ogm had unilateral subfrontal approach between 1st of. After interruption of the blood supply, the tumor was debulked and removed figure 2. My last two have shown growth, and my neurologist says its time to have it removed. Apparently, the concern is a potential increase in the rate of complications by the defect created at the cranial base.
The surgical strategy and outcome for 129 patients operated for an olfactory groove meningioma is retrospectively analyzed. Tumors in this location may cause symptoms such as loss of smell and taste, blurred vision, memory loss, headaches, fatigue, nausea and vomiting, and personality changes. Unilateral subfrontal approach for giant olfactory groove. Given a tendency for infiltrative recurrence along the skull base, this disease represents an important area of collaboration between neurosurgery and otolaryngology. Olfactory groove meningiomas develop insidiously and their diagnosis is commonly made late, when tumors are large. Surgery for an olfactory groove meningioma forms an integral part in the curriculum of a neurosurgeon. Clival and olfactory groove meningiomas radiology case. Olfactory groove meningioma meningioma of olfactory. Olfactory groove meningiomas comprise 410% of the intracranial meningiomas.
If you have an olfactory groove meningioma, you probably will not experience any symptoms until the tumor grows to a large size. Olfactory groove meningiomas account for 8 to % of all intracranial meningiomas. Delayed diagnosis is the rule rather than the exception. An olfactory groove meningioma is a rare benign tumor with a rather insidious course. Olfactory groove meningioma, may be atypical as bright signal on diffusion. Diagrams showing surgical approaches used for ogm resection in this study. Because of the location of acoustic neuromas, the initial symptoms of these tumors involve hearing and balance.
Despite advances in imaging and therapeutic measures, the average size of these tumors at the time of surgical resection has not changed over the past few decades. Meningiomas of the skull base pdf free download ebook description meningiomas, the second most frequent of intracranial tumors, are characterized by a protean range of possible locations and appearances, due to their origin from the extensive and intricately formed meninges. Pdf olfactory groove meningioma case report researchgate. We report a case of a 49yearold woman with an olfactory groove schwannoma attached to.
Olfactory groove meningiomas comprise 4 to 10% of the intracranial meningiomas. Olfactory groove meningioma surgery using eea upmc. Recurrence of olfactory groove meningiomas neurosurgery. Olfactory groove meningiomas arise over the cribriform plate and frontosphenoid suture and comprise approximately 10% of intracranial meningiomas.
This website provides free medical books this website provides over 0 free medical books and more for all students and doctors this website the best choice for. Postsurgical scan show the successful removal of the large tumor via eea surgery. Pdf olfactory groove meningiomas hakan tuna academia. In this case report, a patient with an olfactory groove meningioma presenting with signs and symptoms of transtentorial herniation in the absence of tumorassociated hemorrhage is discussed. Generally they give signs of brain compression due to great size. Presurgical scan shows a large olfactory groove meningioma. Meningiomas originating from the olfactory groove account for approximately 10% of all intracranial meningiomas. Olfactory groove and tuberculum sellae meningiomas are the most frequent tumors located in the frontobasal midline.
Traditional surgery would require a long scalp incision and lifting the front of the brain to get to the olfactory groove meningioma. Pdf olfactory groove meningiomas comprise 410% of the intracranial meningiomas. Clinical suspicion towards intracranial neoplasms must be raised when longstanding. They arise in the midline of the anterior fossa over the cribriform plate of the ethmoid bone and the planum sphenoidale 10,24. Olfactory grooveplanum sphenoidale meningiomas springerlink. The slow progression of symptoms in many cases may be accompanied by apathy in these patients, which decreases the likelihood they will seek medical care.
Olfactory function in patients with olfactory groove. Olfactory groove meningiomas are a relatively uncommon type of intracranial meningioma. Principles of transcranial resection olfactory groove meningiomas ogms constitute 918% of all intracranial meningiomas. A large olfactory groove meningioma displacing the anterior cerebral complex seen by magnetic resonance imaging left and magnetic resonance angiography right. Olfactory groove meningiomas ogms account for 8%% of all intracranial meningiomas 10, 11. Olfactory groove meningioma following radiation therapy. Extension into the ethmoid sinuses has been reported to occur in 15% of patients,6. Mri brain revealed olfactory groove meningioma with associated peritumoral oedema. The olfactory groove schwannoma is a quite rare tumor. In histological series they represent 8%18% of all intracranial meningiomas in histological series.
Despite being separated in its origin by a short distance, they have quite different clinical, radiological, and anatomical relationships. Anderson cancer center, department of neurosurgery, houston, texas 770304009, usa. Olfactory groove meningiomas compromise approximately 818% of intracranial meningiomas and harbor frequently large sizes when diagnosticated. Since i am having parathyroid surgery friday, he said its okay for it to wait a year. We evaluated the role of unilateral subfrontal approach for the removal of giant ogm bigger than 6cm. Olfactory groove meningiomas ogms are rare, slowgrowing tumors that account for 10% of intracranial meningiomas. Inside the skull, and covering the brain, are 3 thin sheets of body tissue. Olfactory groove meningiomas ogms arise over the cribriform plate and may reach very large sizes prior to presentation. The patient developed antons syndromebinocular visual loss with blindness denial.
Olfactory groove meningiomas are benign tumors that grow along the midline floor of the anterior cranial fossa. Their microscopic appearance, pathologic classification, and female preponderance reflect the characteristics of meningiomas found elsewhere. Olfactory groove and sphenoid wing meningiomas columbia. They can be differentiated from tuberculum sellae meningiomas because ogms arise more anterior in the skull base and displace the optic nerve and chiasm inferiorly rather than superiorly. Olfactory groove meningiomas ogm are relatively rare tumors representing approximately 4% to % of all. Olfactory groove meningioma surgery has been associated with complications that include cerebrospinal fluid leak, fatal meningitis, worsening vision, motor deficit, and incomplete removal of tumor 7,17,31,46. Figure 2 from operative techniques olfactory groove. Olfactory groove meningioma the neurosurgical atlas, by. There is a second larger extraaxial lesion arising in the floor of the anterior cranial fossa in the region of the olfactory groove measuring 30 x 38 x 39 mm. Olfactory groove and suprasellar meningiomas springerlink. The neurosurgical atlas is committed to promoting neurosurgical education free of charge.
The clinical records of 27 patients diagnosed of olfactory groove meningioma, extracted from the series of meningiomas operated on in our department since 1973, were. This paper will deal, in the main, with those arising from the olfactory groove and from the jugum sphenoidale tuberculum sellae or from a mixture of the two, and while the latter group are frequently termed suprasellar meningiomas, the author prefers the term meningioma of the jugum sphenoidale since that more nearly describes their. The principal symptoms associated with olfactory groove meningiomas are anosmia and headache. Smaller similar lesion in the right temporal region close to the sphenoid wing. The surgical approaches and factors influencing prognosis. Endoscopeassisted endonasal versus supraorbital keyhole resection of olfactory groove meningiomas. Symptoms of olfactory groove and sphenoid wing meningiomas. The patient was then taken to the operating room, where a bifrontal craniotomy was performed. Anterior cerebral artery, olfactory groove meningioma, optic nerves. Pdf olfactory groove meningiomas surgical technique and. Olfactory function in patients with olfactory groove meningioma. We report a case of a 49yearold woman with an olfactory groove schwannoma attached to the cribriform plate without olfactory dysfunction.
Discussion of clinical presentation and surgical outcomes following excision via the subcranial. Radiotherapy as primary treatment of olfactory groove. Olfactory groove meningioma is a rare clinical entity. Case history a 49yearold woman was admitted to our hospital for the first time in 1967 because of nasal obstruction and epistaxis. Olfactory groove meningiomas demonstrate a propensity to spread into the paranasal sinuses, particularly in recurrent cases. Tinnitus ringing in the ears, hearing loss, disequilibrium, and vertigo are common and caused by compression of the eighth cranial nerve. One hundred and twenty nine patients with an olfactory groove meningioma operated between the years 1987 and 2016 were analyzed on the basis of clinical and radiological factors that appeared to affect the conduct of. The laryngoscope vc 2011 the american laryngological, rhinological and otological society, inc. Intra operative findings consistent with extra axial mass in relation to olfactory groove. These are called the meninges and also help to protect the brain. We report consecutive cases operated on hospital sao paulo and hospital professor edmundo vasconcelos. This is the name given to the protective lining of the brain and spinal cord. Dorsal clival meningioma indenting the cervicomedullary junction.
Olfactory groove meningiomamicrosurgical removaldr. Olfactory groove and sphenoid wing meningiomas nj surgeon. Meyers is snis 2010 annual meeting chairman announcing dr. This 68 yrs lady had large olfactory groove meningioma,this was removed completely microsurgically through bifrontal craniotomy,fronto nasal osteotomy sub frontal approach,with excellent out come. Olfactory groove meningiomas are commonly diagnosed when their size is significant and causes local mass effect. Nakamura m, struck m, roser f, vorkapic p, samii m. The surgical approaches and factors influencing prognosis ramesh c mishra 1, shashwat mishra 2 1 department of neurosurgery, global rainbow healthcare, agra, uttar pradesh, india 2 department of neurosurgery, all india institute of medical sciences, new delhi, india. These tumors arise in the midline of the anterior cranial fossa at the junction of. Olfactory groove and planum sphenoidale meningiomas occur along the anterior cranial base overlying the area of the cribriform plate of the ethmoid bone. Olfactory groove meningiomas tsikoudas 1999 clinical. Has anyone had olfactory groove meningioma surgery. Andersons spasticity program has grown by leaps and bounds aneurysm aneurysm clipping aneurism anuerysm angevine brings spinal deformity expertise to aans 20 ankylosing spondylitis ann riley finck wins columbias clinical nursing excellence award announcement.
494 648 1501 162 37 907 451 833 104 865 442 427 292 1454 597 392 290 1189 202 922 386 667 1395 572 1155 239 641 949 662 637 1489 461 132 560 128 759