The Pterional Approach for the Microsurgical Removal of Olfactory Groove Meningiomas

The Pterional Approach for the Microsurgical Removal of Olfactory Groove Meningiomas AbstractOBJECTIVECurrently, the surgical approach to olfactory meningiomas can vary depending on the size and expansion of the tumor, although surgical treatment still relies on the anterior bilateral craniotomy. Since 1989, we have use the pterional approach as a standard procedure in the treatment of 37 consecutive cases. We present our results in an attempt to contribute an alternative and valid surgical strategy for the treatment of these tumors.METHODSBetween 1989 and 1996, a series of 37 consecutive patients underwent microsurgical tumor resection using the unilateral pterional approach; all patients except one underwent operations on the right side. In 23 patients (62%), the tumor diameter measured approximately 6 cm, and the size was less than 4 cm in only 5 patients. The clinical presentation included mental dysfunction in 27 patients and visual impairment in 16 patients. The advantages of this approach are the early recognition of the posterior cerebrovascular complex, followed by a safe, rapid, and complete devascularization of the tumor and later by a favorable dissection of the capsular area from the frontal vascular branches and parenchyma.RESULTSTotal removal was achieved in all cases. There was one death unrelated to surgery. All patients presenting with mental dysfunction or with preoperative visual deficits recovered or improved. Postoperative magnetic resonance imaging confirmed complete tumor removal and demonstrated the brain parenchyma to be preserved and intact, primarily on the side opposite from the craniotomy.CONCLUSIONOur experience with the pterional approach suggests a greater role for this procedure in the treatment of olfactory groove meningiomas. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

The Pterional Approach for the Microsurgical Removal of Olfactory Groove Meningiomas

The Pterional Approach for the Microsurgical Removal of Olfactory Groove Meningiomas

SU RG ICA L APPROACH The Pterional Approach for the Microsurgical Removal of Olfactory Groove Meningiomas Sergio Turazzi, M.D., Luciano Cristofori, M.D., Roberta Gambin, M.D., Albino Bricolo, M.D. Department of Neurosurgery, University City Hospital, Verona, Italy OBJECTIVE: C urrently, the surgical approach to o lfacto ry meningiomas can vary depending on the size and expansion of the tum or, although surgical treatm ent still relies on the an terio r b ilateral cran io to m y. Since 1989, we have use the pterional approach as a standard procedure in the treatm ent of 37 consecutive cases. We present our results in an attem pt to contribu te an altern ative and valid surgical strategy for the treatm ent of these tumors. METHODS: Between 1989 and 1996, a series of 37 consecutive patients underwent microsurgical tumor resection using the unilateral pterional approach; all patients except one underwent operations on the right side. In 23 patients (62%), the tumor diameter measured approximately 6 cm, and the size was less than 4 cm in only 5 patients. The clinical presentation included mental dysfunction in 27 patients and visual impairment in 16 patients. The advantages of this approach are the early recognition of the posterior cerebrovascular complex, followed by a safe, rapid, and complete devascularization of the tumor and later by a favorable dissection of the capsular area from the frontal vascular branches and parenchyma. RESULTS: Total removal was achieved in all cases. There was one death unrelated to surgery. All patients presenting with mental dysfunction or with preoperative visual deficits recovered or improved. Postoperative magnetic resonance imaging confirmed complete tumor removal and demonstrated the brain parenchyma to be preserved and intact, prim arily on the side opposite from the craniotomy. CO N CLUSIO N : O ur experience with the pterional approach suggests a greater role for this procedure in the treatment of olfactory groove meningiomas....
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199910000-00016
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVECurrently, the surgical approach to olfactory meningiomas can vary depending on the size and expansion of the tumor, although surgical treatment still relies on the anterior bilateral craniotomy. Since 1989, we have use the pterional approach as a standard procedure in the treatment of 37 consecutive cases. We present our results in an attempt to contribute an alternative and valid surgical strategy for the treatment of these tumors.METHODSBetween 1989 and 1996, a series of 37 consecutive patients underwent microsurgical tumor resection using the unilateral pterional approach; all patients except one underwent operations on the right side. In 23 patients (62%), the tumor diameter measured approximately 6 cm, and the size was less than 4 cm in only 5 patients. The clinical presentation included mental dysfunction in 27 patients and visual impairment in 16 patients. The advantages of this approach are the early recognition of the posterior cerebrovascular complex, followed by a safe, rapid, and complete devascularization of the tumor and later by a favorable dissection of the capsular area from the frontal vascular branches and parenchyma.RESULTSTotal removal was achieved in all cases. There was one death unrelated to surgery. All patients presenting with mental dysfunction or with preoperative visual deficits recovered or improved. Postoperative magnetic resonance imaging confirmed complete tumor removal and demonstrated the brain parenchyma to be preserved and intact, primarily on the side opposite from the craniotomy.CONCLUSIONOur experience with the pterional approach suggests a greater role for this procedure in the treatment of olfactory groove meningiomas.

Journal

NeurosurgeryOxford University Press

Published: Oct 1, 1999

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