title: The trans-frontal-sinus subcranial approach for removal of large olfactory groove meningiomas: surgical technique and comparison to other approaches.
abstract: OBJECTIVE
  Several surgical approaches have been previously reported for the treatment of olfactory groove meningiomas (OGM).The trans-frontal-sinus subcranial approach (TFSSA) for the removal of large OGMs is described, comparing it with other reported approaches in terms of advantages and drawbacks.
  
  
  METHODS
  The TFSSA was performed on cadaveric specimens to illustrate the surgical technique.
  
  
  RESULTS
  The surgical steps of the TFSSA and the related anatomical pictures are reported. The approach was adopted in a clinical setting; a case illustration is reported to demonstrate the feasibility of the described approach and to provide intraoperative pictures.
  
  
  CONCLUSIONS
  The TFSSA represents a possible route to treat large OGMs. The subcranial approach provides early devascularization of the tumor, direct tumor access from the base without traction on the frontal lobes, good overview of dissection of the optic nerves and anterior cerebral arteries, and dural reconstruction with pedicled pericranial flap.
authors.affiliation: Department of Neurosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milano, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Boari
authors.forename: Filippo
authors.initials: F
authors.lastname: Gagliardi
authors.forename: Fabio
authors.initials: F
authors.lastname: Roberti
authors.forename: Lina Raffaella
authors.initials: LR
authors.lastname: Barzaghi
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Caputy
authors.forename: Pietro
authors.initials: P
authors.lastname: Mortini
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000601:surgery*; D002102:Cadaver; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005626:Frontal Sinus / Q000601:surgery*; D006801:Humans; D008297:Male; D008579:Meningioma / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D009830:Olfactory Bulb / Q000601:surgery*; D019291:Skull Base / Q000601:surgery; D013524:Surgical Flaps / Q000601:surgery; D016896:Treatment Outcome