Objective: Many approaches have been used for surgical removal of olfactory groove meningioma (OGM) as pterional, bifrontal, interhemispheric, and frontolateral approach. We evaluated the role of unilateral subfrontal...Objective: Many approaches have been used for surgical removal of olfactory groove meningioma (OGM) as pterional, bifrontal, interhemispheric, and frontolateral approach. We evaluated the role of unilateral subfrontal approach for the removal of giant OGM “bigger than 6-cm”. Patients and Methods: Nine patients with giant OGM had unilateral subfrontal approach between 1st of January 2015 and December 2017 in Cairo University Hospitals. A retrospective study we done analyzing clinical data, neuroimaging, surgical result and extent of tumor resection. Results: Total tumor resection was achieved in seven cases “Simpson grade I and II”. Subtotal resection was achieved in two cases, one case there was enchasing of the anterior cerebral artery. The other case subtotal resection was achieved due to old age of the patient. The frontal air sinus and cribriform plate and ethmoidal sinus were repaired using fat, fascia lata and vascularized pericranium flab with the use of histoacryl: One case developed hydrocephalus which required the insertion of a ventriculo-peritoneal shunt. One case developed wound infection and meningitis which required medical treatment only. There is no case of CSF leak or mortality in our series. Conclusion: The unilateral subfrontal approach is a safe and efficient approach for removal of giant olfactory groove meningioma. It combines the benefits of the bifrontal, frontolateral and pterional approach with early access to CSF drainage and early attack of the blood supply of the tumor.展开更多
A modification of the transbasal approach of Dorome called extensive subfrontal approach and the surgical results with this approach in 22 cases are presented. Bilateral frontal craniotomies incorporated with the remo...A modification of the transbasal approach of Dorome called extensive subfrontal approach and the surgical results with this approach in 22 cases are presented. Bilateral frontal craniotomies incorporated with the removal of orbital ridges and part of the orbital roofs were fashioned en bloc. It may give rise to good exposure of the midline lesions of the anterior, middle and posterior skull base, minimizing the need for the retraction of frontal lobes. There was no surgical mortality in this series of cases. Of the 20 cases with tumors, total resections were achieved in 11 cases, subtotal or large resections in 4 cases and partial resection in one case. Two patients with spontaneous rhinorrhea were successively treated surgically, 21 patients had a follow-up with a time ranging from 1-11 years (a mean of 3 years). 15 patients resumed their jobs with no evidence of recurrence of the original disease, and 5 patients able to live self-care. One patient with an olfactory neuroblastoma died 3 years after the operation owing to relapse of the tumor.展开更多
文摘Objective: Many approaches have been used for surgical removal of olfactory groove meningioma (OGM) as pterional, bifrontal, interhemispheric, and frontolateral approach. We evaluated the role of unilateral subfrontal approach for the removal of giant OGM “bigger than 6-cm”. Patients and Methods: Nine patients with giant OGM had unilateral subfrontal approach between 1st of January 2015 and December 2017 in Cairo University Hospitals. A retrospective study we done analyzing clinical data, neuroimaging, surgical result and extent of tumor resection. Results: Total tumor resection was achieved in seven cases “Simpson grade I and II”. Subtotal resection was achieved in two cases, one case there was enchasing of the anterior cerebral artery. The other case subtotal resection was achieved due to old age of the patient. The frontal air sinus and cribriform plate and ethmoidal sinus were repaired using fat, fascia lata and vascularized pericranium flab with the use of histoacryl: One case developed hydrocephalus which required the insertion of a ventriculo-peritoneal shunt. One case developed wound infection and meningitis which required medical treatment only. There is no case of CSF leak or mortality in our series. Conclusion: The unilateral subfrontal approach is a safe and efficient approach for removal of giant olfactory groove meningioma. It combines the benefits of the bifrontal, frontolateral and pterional approach with early access to CSF drainage and early attack of the blood supply of the tumor.
文摘A modification of the transbasal approach of Dorome called extensive subfrontal approach and the surgical results with this approach in 22 cases are presented. Bilateral frontal craniotomies incorporated with the removal of orbital ridges and part of the orbital roofs were fashioned en bloc. It may give rise to good exposure of the midline lesions of the anterior, middle and posterior skull base, minimizing the need for the retraction of frontal lobes. There was no surgical mortality in this series of cases. Of the 20 cases with tumors, total resections were achieved in 11 cases, subtotal or large resections in 4 cases and partial resection in one case. Two patients with spontaneous rhinorrhea were successively treated surgically, 21 patients had a follow-up with a time ranging from 1-11 years (a mean of 3 years). 15 patients resumed their jobs with no evidence of recurrence of the original disease, and 5 patients able to live self-care. One patient with an olfactory neuroblastoma died 3 years after the operation owing to relapse of the tumor.
