Lateral supraorbital approach for resection of large and giant olfactory groove meningiomas: a single center experience

Figures & data

Figure 1. Preoperative sagittal (A), axial (B), and coronal (C) T1-weighted MRI with gadolinium depicting a large OGM with mass effect on the surrounding frontal lobes. The patient underwent a right LSO approach with Simpson grade II resection of the tumor as demonstrated on the postoperative sagittal (D), axial (E), and coronal (F) T1-weighted postcontrast MRI.

Table 1. Patients and tumor characteristics.

Patient	Age (years)	Gender	Clinical presentation	Tumor volume (cm^3)	WHO grade
I	56	Female	Anosmia, headache (bifrontal), seizures, and weight gain	30.0	2
II	51	Female	Anosmia, mental and visual disturbances, headache, and weight gain	165.8	1
III	55	Female	Mental disturbances andweight gain	124.0	1
IV	84	Male	Headache, visual disturbances (diplopia, blurred vision), ataxia, and weight gain	30.3	1
V	64	Female	Mental and visual disturbances, headache, and weight gain	179.3	1
VI	81	Female	Anosmia, mental disturbances, and weight gain	173.4	1
VII	53	Female	Anosmia, mental disturbances, headache (sinus), syncope, and weight gain	141.7	1

WHO: World Health Organization.

Table 2. Patients’ outcomes following LSO approach.

Patient	Simpson resection grade	Complications	Residual location	LOS ICU (days)	LOS hospital	Preoperative KPS	KPS at last follow-up
I	II	None	None	None	2.6	80	100
II	IV	None	Ethmoidal and planum sphenoidale	None	2.4	70	100
III	II	None	None	None	1.7	70	90
IV	II	Frontal sinus breach, CSF Leak, Pneumocephalus	None	None	1.4	80	100
V	II	None	None	2.0	2.6	50	90
VI	IV	None	Ethmoidal and base of sphenoid sinus	1.5	2.6	70	90
VII	IV	Transient diplopia	Ethmoidal and olfactory groove	None	1.1	60	100

ICU: Intensive care unit; LOS: length of stay; KPS: Karnofsky Performance Scale; CSF: cerebrospinal fluid.

Table 3. Follow-up and adjuvant therapy.

Patient	Follow-up duration (months)	Recurrence/progression	Interval between surgery and recurrence/progression (months)	Adjuvant therapy	Interval between surgery and adjuvant therapy (Months)	Marginal dose of GKRS (Gy)	Follow-up duration post-GKRS (months)	Tumor response to GKRS
I	85.0	None	–	None	–	–	–	–
II	82.6	Yes	15.4	GKRS	76.4	13.0	6.2	Regressed
III	87.1	None	–	None	–	–	–	–
IV	82.3	None	–	None	–	–	–	–
V	51.0	None	–	None	–	–	–	–
VI	36.6	None	–	None	–	–	–	–
VII	34.0	Yes	13.8	GKRS	14.2	12.5	6.8	Stable

GKRS: Gamma Knife radiosurgery.