title: Olfactory groove meningioma: discussion of clinical presentation and surgical outcomes following excision via the subcranial approach.
abstract: OBJECTIVE
  To describe surgical outcomes and radiographic features of olfactory groove meningiomas treated by excision through the subcranial approach. Special emphasis is placed on paranasal sinus and orbit involvement.
  
  
  METHODS
  Retrospective review of a series of patients.
  
  
  METHODS
  Nineteen patients underwent excision of olfactory groove meningioma (OGM) via the transglabellar/subcranial approach between December 1995 and November 2009. Nine patients had previously undergone prior resection at outside institutions, and four had prior radiotherapy in addition to a prior excision. Transglabellar/subcranial surgical approach to the anterior skull base was performed.
  
  
  RESULTS
  Tumor histology included three World Health Organization (WHO) grade III lesions, one WHO grade II lesion, and 15 WHO grade I lesions. Fourteen patients had evidence of extension into the paranasal sinuses, with the ethmoid sinus being most commonly involved. Kaplan-Meier estimates of mean overall and disease-free survival were 121.45 months and 93.03 months, respectively. The mean follow-up interval was 41.0 months, and at the time of data analysis three patients had recurrent tumors. Seven (36.8%) patients experienced a major complication in the perioperative period; there were no perioperative mortalities. Orbit invasion was observed in four patients, with optic nerve impingement in 11 patients. Of these, three patients had long-term diplopia. No patients experienced worsening of preoperative visual acuity.
  
  
  CONCLUSIONS
  Olfactory groove meningiomas demonstrate a propensity to spread into the paranasal sinuses, particularly in recurrent cases. Given a tendency for infiltrative recurrence along the skull base, this disease represents an important area of collaboration between neurosurgery and otolaryngology. The subcranial approach offers excellent surgical access for excision, particularly for recurrences that involve the paranasal sinuses and optic apparatus.
authors: Department of Otolaryngology-Head and Neck Surgery, University of Michigan Hospital System, Ann Arbor, Michigan, USA.
authors: Jon-Paul
authors: JP
authors: Pepper
authors: Sarah L
authors: SL
authors: Hecht
authors: Stephen S
authors: SS
authors: Gebarski
authors: Erin M
authors: EM
authors: Lin
authors: Stephen E
authors: SE
authors: Sullivan
authors: Lawrence J
authors: LJ
authors: Marentette
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D008579:Meningioma / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012086:Reoperation; D012189:Retrospective Studies; D019291:Skull Base / Q000601:surgery; D016896:Treatment Outcome