Olfactory groove meningiomas: postoperative preservation of olfactory and visual functions, evaluation of risk factors
EANS Academy. Stastna D. 09/25/19; 275863; EP04005
Daniela Stastna
Daniela Stastna

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Background: Olfactory groove meningiomas (OGM) put patients' olfaction and vision at risk, often insidiously. We aimed was determine the frequency and features associated with pre- and postoperative visual and olfactory.
Methods: We retrospectively analysed records of 76 patients who underwent surgical resection of OGM between 2002-2018, focusing on preservation of olfaction and vision in relation to demographic, clinico-radiological and surgical variables. Chi-square, Fisher`s exact, Anova tests, Kaplan-Meier study were used when appropriate.
Results: 90% of the OGM had maximal diameter >4cm; 26% with PS extension.
Approaches: bifrontal transbasal (59%), interhemispheric(22%), unilateral fronto-temporal(16%) or endoscopic(3%) approaches. Simpson 1 or 2 resection was achieved in 69 patients (91%). Five-year tumour control rates were: 88%; 82% and 75% for bifrontal transbasal, interhemispheric and fronto-temporal approaches, respectively.
Thirty patients (42%) affirmed preoperative olfaction. Of those, 53% retained olfaction post-operatively.
Preoperative anosmia was associated with edema, calcification and seizures (p=0.0463, 0.012, 0.007, respectively). Olfaction preservation by approach: fronto-temporal (67% of patients): bifrontal (56%); interhemispheric approach (29%). New postoperative anosmia was associated with OGM extension towards midpupillary line (p=0.013).
Preoperatively, 24% of patients had unilateral and 12% bilateral visual deficit. Postoperatively, vision improved in 38% patients with unilateral visual deficit, but only in 11% of patients with bilateral deficit. 65% of patients had intact vision and most of them (98%) preserved it after the surgery. Preoperative visual deficit correlated with tumor volume (p=0.004) and calcification(p=0.047). Postoperative visual deterioration was only associated with presurgical visual deficit (p=0.0001).
Conclusions: Post-operative olfactory preservation was related lateral extension and unilateral approach. Post-operative visual function was closely related to pre-operative visual status.
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