title: Lateral supraorbital approach applied to olfactory groove meningiomas: experience with 66 consecutive patients.
abstract: OBJECTIVE
  The lateral supraorbital approach for safely and completely removing olfactory groove meningiomas was assessed.
  
  
  METHODS
  Between September 1997 and June 2008, a total of 656 meningiomas were operated on by the senior author (JH) at the Department of Neurosurgery, Helsinki University Central Hospital; 66 were olfactory meningiomas. We retrospectively analyze the clinical data, radiological findings, surgical treatment, histology, and outcome of all the olfactory groove meningioma patients and discuss the operative techniques used.
  
  
  RESULTS
  Sixty-six patients were operated on by the lateral supraorbital approach. The median preoperative Karnofsky Performance Scale score was 80 (range, 40-100). Three patients were redo cases in which the primary operation had been performed elsewhere. Seemingly complete tumor removal was achieved in 60 patients (91%); there was no surgical mortality. Postoperatively, 6 patients (9%) had cerebrospinal fluid leakage, 5 (8%) had new visual deficits, 4 (6%) had wound infections, 4 (6%) had cotton granulomas, and 1 (2%) had a postoperative hematoma. The median Karnofsky score at discharge was 80 (range, 40-100). Six patients had recurrent tumors; 3 underwent reoperations after an average of 21 months (range, 1-41 months); 1 was treated with radiosurgery, and 2 were only followed. During the median follow-up time of 45 months (range, 2-128 months), there were 4 recurrences (6%) diagnosed on average 32 months (range, 17-59 months) after surgery.
  
  
  CONCLUSIONS
  The lateral supraorbital approach can be used safely for olfactory groove meningiomas of all sizes with no mortality and relatively low morbidity. Surgical results and tumor recurrence with this fast and simple approach are similar to those obtained with more extensive, complex, and time-consuming approaches.
authors: Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland.
authors: Rossana
authors: R
authors: Romani
authors: Martin
authors: M
authors: Lehecka
authors: Emilia
authors: E
authors: Gaal
authors: Stefano
authors: S
authors: Toninelli
authors: Ozgür
authors: O
authors: Celik
authors: Mika
authors: M
authors: Niemelä
authors: Matti
authors: M
authors: Porras
authors: Juha
authors: J
authors: Jääskeläinen
authors: Juha
authors: J
authors: Hernesniemi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005624:Frontal Bone / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008577:Meningeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008579:Meningioma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome