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Unilateral frontal interhemispheric transfalcial approaches for the removal of olfactory groove meninjiomas
Ahmet Murat Musluman1, Adem Yilmaz, Tufan Canseve R
1Sisli Etfal Research and Education Hospital, Department of Neurosurgery, Istanbul, Turkey. mmusluman@yahoo.com
Aim:
A unilateral subfrontal interhemispheric transfalcial approach for the removal of olfactory groove meningiomas (OGM) was evaluated in terms of surgical technique, complications, clinical outcomes, and recurrence rate.
Material And Methods:
Twenty-four females and eighteen males with a mean age of 59 years were operated on for OGM within a 12- year (1996-2008) period. The pre- and post-operative Mini-Mental Test (MMT) scores, visual impairment scores (VIS), pre-operative clinical symptoms (headache, epileptic seizure and anosmia), Karnofsky performance scores (KPS), tumor size and tumor extensions were evaluated. The effects of the pre-operative parameters on post-operative MMT, VIS and KPS were investigated.
Results:
Tumor size and pre-operative MMT significantly affected pre-operative KPS. Mean tumor diameter was 5.6±0.8 cm. Total excision was achieved in 97.6% of all cases. No peri-operative mortality was seen. Ten patients (23.8%) experienced surgery-related complications. The mean follow-up period of cases was 52 months, and the rate of residual tumor re-growth was 2.3%. No parameter showed any effect on post-operative KPS, as no significant difference was seen between pre- and post-operative KPS. A significant positive difference was detected between pre- and post-operative MMT and VIS.
Conclusion:
A unilateral subfrontal interhemispheric transfalcial approach can be the preferred modality for treating OGM.
