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Olfactory groove meningioma - Impact of the chosen surgical technique on the prognosis
EANS Academy. Nogueira R. Sep 27, 2019; 276106; EP04024
Abstract
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Background: The optimal surgical approach for olfactory groove meningioma allows complete and safe removal of the tumor. It should include adequate exposure of anatomical structures with minimal brain manipulation, reducing postoperative morbidity.
Methods: It was determined the impact on the prognosis, by age (>70 vs < 70 years), gender, tumor diameter (> 6cm vs < 6cm), Karnofsky PS (> 70 vs < 70) preoperative and postoperative, extension of resection (simpson I-II vs III-V), histological classification of the WHO, as well as the surgical approach (pterional with anterior extension vs bifrontal).
Results: Between 2011 and 2017, 29 patients with olfactory groove meningioma (average of 57 years) were operated in our center, of which 19 were female. The anterior extension approach (n = 9) allowed a greater tumor removal (Simpson I-II), compared to the bifrontal approach (n = 20). It was verified that the pterional approach allowed a lesser retraction of the frontal lobe. The bifrontal approach presented a higher prevalence of complications (infection and CSF leak). Age < 70 years, tumor diameter < 6cm, pre and postoperative KPS> 70, Simpson I-II and grade I histological classification (WHO) were associated with a better prognosis.
Conclusions: In our serie, the pterional approach allowed a greater and safer tumor removal - it allows a better visualization of the neurovascular structures and a less cerebral retraction. It showed a lower prevalence of complications and allowed a better cosmetic result.
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