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DOI: 10.1055/s-0044-1779916
Olfactory Groove Meningiomas: Supraorbital Keyhole Versus Orbitofrontal, Frontotemporal or Bifrontal Approaches
Authors
Introduction: Olfactory groove meningiomas often require surgical removal. The introduction of recent keyhole approaches raises the question of whether these tumors may be better treated through a smaller cranial opening. One such approach, the supraorbital keyhole craniotomy, has never been compared with more traditional open transcranial approaches with regards to outcome.
Objective: A comparison of clinical, radiographic, and functional quality of life (QOL) outcomes between keyhole SOA and open/transcranial approaches (TCA) for OGMs.
Methods: A retrospective, single-institution review of 57 patients undergoing a keyhole SOA or larger transcranial (TCA: frontotemporal, pterional, bifrontal) craniotomy for newly diagnosed OGMs between 2005-2023 was performed. Extent of resection, olfaction, length of stay (LOS), radiographic volumetric assessment of post-operative vasogenic and cytotoxic edema, and a quality of life (Anterior Skull Base Questionnaire) were assessed.
Results: Thirty-two SOA and 25 TCA patients were included. Mean EOR was not significantly different by approach (TCA: 99.1% vs. SOA: 98.4%, p = 0.91). Olfaction was preserved or improved at similar rates (TCA: 47% vs. SOA: 45%, p = 0.99). Mean LOS was significantly shorter for SOA (4.1 ± 2.8 days) vs. TCA (9.9 ± 11.6; p = 0.002). An association with increase in postoperative FLAIR cerebral edema was noted for TCA patients relative to SOA (p = 0.031). QOL as assessed by ASQB at last follow up did not differ significantly between groups (p = 0.74).
Conclusions: The keyhole SOA was associated with a significant decrease in LOS and less postoperative edema relative to larger open approaches.
Publication History
Article published online:
05 February 2024
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