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Bitter AD, Stavrinou LC, Ntoulias G, et al. The Role of the Pterional Approach in the Surgical Treatment of Olfactory Groove Meningiomas: A 20-year Experience. J Neurol Surg B Skull Base. 2013;74(2):97-102doi: 10.1055/s-0033-1333618.
Bitter, A. D., Stavrinou, L. C., Ntoulias, G., Petridis, A. K., Dukagjin, M., Scholz, M., & Hassler, W. (2013). The Role of the Pterional Approach in the Surgical Treatment of Olfactory Groove Meningiomas: A 20-year Experience. Journal of neurological surgery. Part B, Skull base, 74(2), 97-102. https://doi.org/10.1055/s-0033-1333618
Bitter, Andrej D, et al. "The Role of the Pterional Approach in the Surgical Treatment of Olfactory Groove Meningiomas: A 20-year Experience." Journal of neurological surgery. Part B, Skull base vol. 74,2 (2013): 97-102. doi: https://doi.org/10.1055/s-0033-1333618
Bitter AD, Stavrinou LC, Ntoulias G, Petridis AK, Dukagjin M, Scholz M, Hassler W. The Role of the Pterional Approach in the Surgical Treatment of Olfactory Groove Meningiomas: A 20-year Experience. J Neurol Surg B Skull Base. 2013 Apr;74(2):97-102. doi: 10.1055/s-0033-1333618. Epub 2013 Jan 22. PMID: 24436895; PMCID: PMC3699215.
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J Neurol Surg B Skull Base. 2013 Apr;74(2):97-102. doi: 10.1055/s-0033-1333618. Epub 2013 Jan 22.

The Role of the Pterional Approach in the Surgical Treatment of Olfactory Groove Meningiomas: A 20-year Experience.

Journal of neurological surgery. Part B, Skull base

Andrej D Bitter, Lampis C Stavrinou, Georgios Ntoulias, Athanasios K Petridis, Morina Dukagjin, Martin Scholz, Werner Hassler

Affiliations

  1. Department of Neurosurgery, Klinikum Duisburg, Duisburg NRW, Germany.
  2. Department of Neurosurgery, Evangelisches Krankenhaus Bielefeld, Bielefeld NRW, Germany.

PMID: 24436895 PMCID: PMC3699215 DOI: 10.1055/s-0033-1333618

Abstract

Background Olfactory groove meningiomas remain surgically challenging. The common microsurgical approaches suffer from late exposure of the neurovascular structures. Conversely, the pterional approach has the advantage of early dissection of the posterior neurovascular complex. Methods We reviewed the records of patients treated for olfactory groove meningioma in our department between 1991 and 2010. A total of 61 patients underwent removal of olfactory groove meningiomas via the pterional approach. These included 58 primary and 3 recurrent tumors. Mean overall follow-up time was 122 months. Results Early exposure and dissection of the internal carotid artery, middle cerebral artery, anterior cerebral artery, and optic nerve was feasible in all cases. Complete tumor removal was achieved in 60 patients. Morbidity and mortality rates were 26% and 1.6% respectively. Postoperative complications included epileptic seizures (five patients) and cerebrospinal fluid (CSF) leak (two patients). During follow-up, we recorded three tumor recurrences. Conclusions The pterional approach appears to be an excellent solution for the treatment of olfactory groove meningiomas. Its foremost advantage is early visualization of the posterior neurovascular complex. Moreover, it allows frontal sinus preservation and timely tumor devascularization and avoids excessive brain retraction. The pterional view is familiar to most neurosurgeons and therefore the transition to this technique is fairly straightforward.

Keywords: meningioma removal; olfactory groove meningiomas; pterional approach; surgical treatment

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