The Trans-Frontal-Sinus Subcranial Approach for Removal of Large Olfactory Groove Meningiomas: Surgical Technique and Comparison to Other Approaches

Nicola Boari; Filippo Gagliardi; Fabio Roberti; Lina Raffaella Barzaghi; Anthony J. Caputy; Pietro Mortini

doi:10.1055/s-0032-1325630

Journal of Neurological Surgery Part A: Central European Neurosurgery, Inhaltsverzeichnis

J Neurol Surg A Cent Eur Neurosurg 2013; 74(03): 152-161
DOI: 10.1055/s-0032-1325630

Original Article

Georg Thieme Verlag KG Stuttgart · New York

The Trans-Frontal-Sinus Subcranial Approach for Removal of Large Olfactory Groove Meningiomas: Surgical Technique and Comparison to Other Approaches

Authors

Nicola Boari

¹Department of Neurosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milano, Italy
Filippo Gagliardi

¹Department of Neurosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milano, Italy
Fabio Roberti

²Department of Neurosurgery, Indian River Medical Center, Vero Beach, Florida, United States

³Department of Neurological Surgery, The George Washington University, Washington, District of Columbia, United States
Lina Raffaella Barzaghi

¹Department of Neurosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milano, Italy
Anthony J. Caputy

³Department of Neurological Surgery, The George Washington University, Washington, District of Columbia, United States
Pietro Mortini

¹Department of Neurosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milano, Italy

Abstract

Background and Study Objective Several surgical approaches have been previously reported for the treatment of olfactory groove meningiomas (OGM).

The trans-frontal-sinus subcranial approach (TFSSA) for the removal of large OGMs is described, comparing it with other reported approaches in terms of advantages and drawbacks.

Material and Methods The TFSSA was performed on cadaveric specimens to illustrate the surgical technique.

Results The surgical steps of the TFSSA and the related anatomical pictures are reported. The approach was adopted in a clinical setting; a case illustration is reported to demonstrate the feasibility of the described approach and to provide intraoperative pictures.

Conclusion The TFSSA represents a possible route to treat large OGMs. The subcranial approach provides early devascularization of the tumor, direct tumor access from the base without traction on the frontal lobes, good overview of dissection of the optic nerves and anterior cerebral arteries, and dural reconstruction with pedicled pericranial flap.

Keywords

olfactory groove meningiomas - anterior cranial base - skull base approaches - surgical technique - anatomical study

Volltext

Referenzen

References
1 Aguiar PH, Tahara A, Almeida AN , et al. Olfactory groove meningiomas: approaches and complications. J Clin Neurosci 2009; 16 (9) 1168-1173
2 Al-Mefty O, Holoubi A, Rifai A, Fox JL. Microsurgical removal of suprasellar meningiomas. Neurosurgery 1985; 16 (3) 364-372
3 Auer LM, Holzer P, Ascher PW, Heppner F. Endoscopic neurosurgery. Acta Neurochir (Wien) 1988; 90 (1–2) 1-14
4 Babu R, Barton A, Kasoff SS. Resection of olfactory groove meningiomas: technical note revisited. Surg Neurol 1995; 44 (6) 567-572
5 Bassiouni H, Asgari S, Stolke D. Olfactory groove meningiomas: functional outcome in a series treated microsurgically. Acta Neurochir (Wien) 2007; 149 (2) 109-121 , discussion 121
6 Bogaev CA, Sekhar LN. Olfactory groove and planum sphenoidale meningiomas. In: Sekhar LN, Fessler RG. Atlas of neurosurgical techniques. Brain. New York: Thieme Medical Publishers; 2006: 608-617
7 Bulsara KR, Al-Mefty O. Skull base surgery for benign skull base tumors. J Neurooncol 2004; 69 (1–3) 181-189
8 Casler JD, Doolittle AM, Mair EA. Endoscopic surgery of the anterior skull base. Laryngoscope 2005; 115 (1) 16-24
9 Cophignon J, George B, Marchac D, Roux F. Voie transbasale élargie par mobilisation du bandeau fronto-orbitaire median. Neurochirurgie 1983; 29 (6) 407-410
10 Cushing H, Eisenhardt L. The olfactory meningiomas with primary anosmia. In: Cushing H, Eisenhardt L. Meningiomas. Springfield, Baltimore: C.C. Thomas; 1938: 250-282
11 de Divitiis E, Cavallo LM, Esposito F, Stella L, Messina A. Extended endoscopic transsphenoidal approach for tuberculum sellae meningiomas. Neurosurgery 2007; 61 (5, Suppl 2) 229-237 , discussion 237–238
12 de Divitiis E, Esposito F, Cappabianca P, Cavallo LM, de Divitiis O, Esposito I. Endoscopic transnasal resection of anterior cranial fossa meningiomas. Neurosurg Focus 2008; 25 (6) E8
13 DeMonte F. Surgical treatment of anterior basal meningiomas. J Neurooncol 1996; 29 (3) 239-248
14 Derome PJ, Guiot G. Bone problems in meningiomas invading the base of the skull. Clin Neurosurg 1978; 25: 435-451
15 Derome PJ. Surgical management of tumours invading the skull base. Can J Neurol Sci 1985; 12 (4) 345-347
16 Durante F. Estirpazione di un tumore endocranico. Arch Soc Ital Chir 1885; 2: 252-255
17 El-Bahy K. Validity of the frontolateral approach as a minimally invasive corridor for olfactory groove meningiomas. Acta Neurochir (Wien) 2009; 151 (10) 1197-1205
18 Fernandez-Miranda JC, Gardner PA, Prevedello DM, Kassam AB. Expanded endonasal approach for olfactory groove meningioma. Acta Neurochir (Wien) 2009; 151 (3) 287-288 , author reply 289–290
19 Fliss DM, Zucker G, Cohen A , et al. Early outcome and complications of the extended subcranial approach to the anterior skull base. Laryngoscope 1999; 109 (1) 153-160
20 Gardner PA, Kassam AB, Thomas A , et al. Endoscopic endonasal resection of anterior cranial base meningiomas. Neurosurgery 2008; 63 (1) 36-52 , discussion 52–54
21 Goffin J, Fossion E, Plets C, Mommaerts M, Vrielinck L. Craniofacial resection for anterior skull base tumours. Acta Neurochir (Wien) 1991; 110 (1–2) 33-37
22 Hadad G, Bassagasteguy L, Carrau RL , et al. A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 2006; 116 (10) 1882-1886
23 Hallacq P, Moreau JJ, Fischer G, Béziat JL. Trans-sinusal frontal approach for olfactory groove meningiomas. Skull Base 2001; 11 (1) 35-46
24 Hassler W, Zentner J. Pterional approach for surgical treatment of olfactory groove meningiomas. Neurosurgery 1989; 25 (6) 942-945 , discussion 945–947
25 Hassler W, Zentner J. Surgical treatment of olfactory groove meningioma using the pterional approach. Acta Neurochir Suppl 1991; 53: 14-18
26 Henderson WR. The anterior basal meningiomas. Br J Surg 1938; 26: 124-132
27 Hentschel SJ, DeMonte F. Olfactory groove meningiomas. Neurosurg Focus 2003; 14 (6) e4
28 Kabil MS, Shahinian HK. Application of the supraorbital endoscopic approach to tumors of the anterior cranial base. J Craniofac Surg 2005; 16 (6) 1070-1074 , discussion 1075
29 Kanaan IN. Trans-eyebrow mini-orbitozygomatic pterional approach for minimally invasive skull base surgery. Minim Invasive Neurosurg 2005; 48 (1) 34-38
30 Kassam A, Snyderman CH, Mintz A, Gardner P, Carrau RL. Expanded endonasal approach: the rostrocaudal axis. Part I. Crista galli to the sella turcica. Neurosurg Focus 2005; 19 (1) E3
31 Kempe LG. Olfactory groove meningioma. In: Kempe LG. Operative Neurosurgery. New-York: Springer-Verlag; 1968: 104-108
32 Long DM. Meningiomas of the olfactory groove and anterior fossa. In: Long DM. Atlas of Operative Neurosurgical Technique: Cranial Operations. Baltimore: Williams & Wilkins. 1989: 238-241
33 Maiuri F, Salzano FA, Motta S, Colella G, Sardo L. Olfactory groove meningioma with paranasal sinus and nasal cavity extension: removal by combined subfrontal and nasal approach. J Craniomaxillofac Surg 1998; 26 (5) 314-317
34 Mayfrank L, Gilsbach JM. Interhemispheric approach for microsurgical removal of olfactory groove meningiomas. Br J Neurosurg 1996; 10 (6) 541-545
35 McDermott MW, Rootman J, Durity FA. Subperiosteal, subperiorbital dissection and division of the anterior and posterior ethmoid arteries for meningiomas of the cribriform plate and planum sphenoidale: technical note. Neurosurgery 1995; 36 (6) 1215-1218 , discussion 1218–1219
36 Melamed I, Merkin V, Korn A, Nash M. The supraorbital approach: an alternative to traditional exposure for the surgical management of anterior fossa and parasellar pathology. Minim Invasive Neurosurg 2005; 48 (5) 259-263
37 Nakamura M, Struck M, Roser F, Vorkapic P, Samii M. Olfactory groove meningiomas: clinical outcome and recurrence rates after tumor removal through the frontolateral and bifrontal approach. Neurosurgery 2007; 60 (5) 844-852 , discussion 844–852
38 Obeid F, Al-Mefty O. Recurrence of olfactory groove meningiomas. Neurosurgery 2003; 53 (3) 534-542 , discussion 542–543
39 Ojemann RG. Management of cranial and spinal meningiomas (honored guest presentation). Clin Neurosurg 1993; 40: 321-383
40 Ojemann RG. Meningiomas of the basal parapituitary region: technical considerations. Clin Neurosurg 1980; 27: 233-262
41 Ojemann RG. Olfactory groove meningiomas. In: Al-Mefty O. Meningiomas. New York: Raven Press; 1991: 383-393
42 Rachinger W, Grau S, Tonn JC. Different microsurgical approaches to meningiomas of the anterior cranial base. Acta Neurochir (Wien) 2010; 152 (6) 931-939
43 Raveh J, Laedrach K, Vuillemin T, Zingg M. Management of combined frontonaso-orbital/skull base fractures and telecanthus in 355 cases. Arch Otolaryngol Head Neck Surg 1992; 118 (6) 605-614
44 Raveh J, Laedrach K, Speiser M , et al. The subcranial approach for fronto-orbital and anteroposterior skull-base tumors. Arch Otolaryngol Head Neck Surg 1993; 119 (4) 385-393
45 Raveh J, Neiger M. Die wiederherstellung bei schweren gesichtsschädelverletzungen. Schweiz Monatsschr Zahnheilkd 1981; 91: 206-217
46 Raveh J, Redli M, Markwalder TM. Operative management of 194 cases of combined maxillofacial-frontobasal fractures: principles and surgical modifications. J Oral Maxillofac Surg 1984; 42 (9) 555-564
47 Raveh J, Turk JB, Lädrach K , et al. Extended anterior subcranial approach for skull base tumors: long-term results. J Neurosurg 1995; 82 (6) 1002-1010
48 Raveh J, Vuillemin T. Advantages of an additional subcranial approach in the correction of craniofacial deformities. J Craniomaxillofac Surg 1988; 16 (8) 350-358
49 Raveh J, Vuillemin T, Sutter F. Subcranial management of 395 combined frontobasal-midface fractures. Arch Otolaryngol Head Neck Surg 1988; 114 (10) 1114-1122
50 Raveh J, Vuillemin T. Subcranial-supraorbital and temporal approach for tumor resection. J Craniofac Surg 1990; 1 (1) 53-59
51 Raveh J, Vuillemin T. The surgical one-stage management of combined cranio-maxillo-facial and frontobasal fractures. Advantages of the subcranial approach in 374 cases. J Craniomaxillofac Surg 1988; 16 (4) 160-172
52 Raveh J. Das einzeitge vorgehan bei der widerherstellung von frontobasal-mittelgesichtsfrakturen. Modifikatinen und behandlungsmodalitaten. Chirurgie 1983; 54: 677-686
53 Raveh J. [New aspects of craniofacial surgery]. Schweiz Monatsschr Zahnmed 1986; 96 (2) 406-424
54 Reisch R, Perneczky A, Filippi R. Surgical technique of the supraorbital key-hole craniotomy. Surg Neurol 2003; 59 (3) 223-227
55 Reisch R, Perneczky A. Ten-year experience with the supraorbital subfrontal approach through an eyebrow skin incision. Neurosurgery 2005; 57 (4, Suppl) 242-255 , discussion 242–255
56 Romani R, Lehecka M, Gaal E , et al. Lateral supraorbital approach applied to olfactory groove meningiomas: experience with 66 consecutive patients. Neurosurgery 2009; 65 (1) 39-52 , discussion 52–53
57 Roux FX, Devaux B, Nataf F , et al. Tumeurs malignes de la région ethmoïdale. Techniques neurochirurgicales. Neurochirurgie 1997; 43 (2) 92-99
58 Rubin G, Ben David U, Gornish M, Rappaport ZH. Meningiomas of the anterior cranial fossa floor. Review of 67 cases. Acta Neurochir (Wien) 1994; 129 (1–2) 26-30
59 Samii M, Ammirati M. Olfactory groove meningiomas. In: Samii M. Surgery of the Skull Base: Meningiomas. Berlin: Springer-Verlag; 1992: 15-25
60 Schaller C, Rohde V, Hassler W. Microsurgical removal of olfactory groove meningiomas via the pterional approach. Skull Base Surg 1994; 4 (4) 189-192
61 Sekhar LN, Nanda A, Sen CN, Snyderman CN, Janecka IP. The extended frontal approach to tumors of the anterior, middle, and posterior skull base. J Neurosurg 1992; 76 (2) 198-206
62 Snyderman CH, Constantino PD, Sekhar LN. Anterior approaches to the cranial base. In: Apuzzo MLJ. Brain surgery: complication avoidance and management. New York: Churchill Livingstone; 1993: 2265-2281
63 Solero CL, Giombini S, Morello G. Suprasellar and olfactory meningiomas. Report on a series of 153 personal cases. Acta Neurochir (Wien) 1983; 67 (3–4) 181-194
64 Spektor S, Valarezo J, Fliss DM , et al. Olfactory groove meningiomas from neurosurgical and ear, nose, and throat perspectives: approaches, techniques, and outcomes. Neurosurgery 2005; 57 (4, Suppl) 268-280 , discussion 268–280
65 Symon L. Olfactory groove and suprasellar meningiomas. In: Krayenbühl H. Advances and Technical Standards in Neurosurgery. Vienna: Springer-Verlag; 1977: 67-91
66 Tamaki N, Yin D. Giant olfactory groove meningiomas: advantages of the bilateral fronto-orbitonasal approach. J Clin Neurosci 1999; 6 (4) 302-305
67 Tsikoudas A, Martin-Hirsch DP. Olfactory groove meningiomas. Clin Otolaryngol Allied Sci 1999; 24 (6) 507-509
68 Turazzi S, Cristofori L, Gambin R, Bricolo A. The pterional approach for the microsurgical removal of olfactory groove meningiomas. Neurosurgery 1999; 45 (4) 821-825 , discussion 825–826
69 Welge-Luessen A, Temmel A, Quint C, Moll B, Wolf S, Hummel T. Olfactory function in patients with olfactory groove meningioma. J Neurol Neurosurg Psychiatry 2001; 70 (2) 218-221