title: Superior interhemispheric approach for midline meningioma from the anterior cranial base.
abstract: BACKGROUND
  For suprasellar meningioma, the fronto-basal exposure is considered the standard approach. The superior interhemispheric (IH) approach is less described in the literature.
  
  
  OBJECTIVE
  To assess the surgical complications, functional outcome (visual, olfaction), morbidity and mortality rates and late recurrence, after resection by superior IH approach of midline skull base meningioma.
  
  
  METHODS
  Between 1998 and 2008, 52 consecutive patients with midline meningioma on the anterior portion of the skull base (mean age: 63.8 ± 13.1; sex ratio F/M: 3.7) were operated on via the superior IH approach. After a mean follow-up of 56.9 ± 32.9 months, an independent neurosurgeon proposed a prospective examination of functional outcome to each patient, as well as a visual and olfactory function assessment.
  
  
  RESULTS
  Fifty-two patients were divided into a group with olfactory groove meningioma (n=34) and another with tuberculum sellae meningioma (n=18). The outcome was characterized by postoperative complications in 13 patients (25%), mortality rate in two (3.8%) and long-term morbidity at in 17 (37%) of 50 surviving patients. Based on multivariate analysis, no prognosis factor was significant as regards the favorable outcome. The mean postoperative KPS score (86.6 ± 9.4) was significantly improved. However, dysexecutive syndrome was observed in four patients (8%), hyposmia-anosmia in 34 (68%) and visual acuity deteriorated in one (2%).
  
  
  CONCLUSIONS
  The superior IH approach could be considered a safe anteriorly orientated midline approach for removal OGM and TSM meningioma.
authors: Department of Neurosurgery, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex, France.
authors: S
authors: S
authors: Lévêque
authors: S
authors: S
authors: Derrey
authors: O
authors: O
authors: Martinaud
authors: E
authors: E
authors: Gérardin
authors: O
authors: O
authors: Langlois
authors: P
authors: P
authors: Fréger
authors: D
authors: D
authors: Hannequin
authors: H
authors: H
authors: Castel
authors: F
authors: F
authors: Proust
mesh_terms: D000368:Aged; D056344:Executive Function / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017567:Karnofsky Performance Status; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D000857:Olfaction Disorders / Q000209:etiology; D055696:Olfactory Perception / Q000502:physiology; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D019291:Skull Base / Q000033:anatomy & histology / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000401:mortality / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014787:Vision Tests; D014792:Visual Acuity / Q000502:physiology