Minimally Invasive Interhemispheric Approach for Giant Olfactory Groove Meningioma: Technical Note.

Libório Dos Santos, Adriana Rodrigues; Calfat Maldaun, Marcos Vinícius; Gripp, Daniel Andrade; Watanabe, Jonathan; Fujiki, Ricardo Hiroshi; Pires de Aguiar, Paulo Henrique · World Neurosurg · 2018

case_report · Level V

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Abstract

Skull base tumors, such as large olfactory groove meningiomas (OGMs), are a challenge for neurosurgeons. However, the tendency to reduce invasive surgeries is gaining more adepts. We describe a minimally invasive interhemispheric approach with a falx window for microsurgical resection of the giant OGM as a technical note. A minimal medial frontal craniotomy measuring 3-5 cm in size is performed, and an interhemispheric approach is combined with an opening in the falx to improve microsurgical resection of the giant OGM. The technique and more details are described. A minimally invasive interhemispheric approach with a falx window was performed in this case. Gross total resection of the OGM was possible with minimal brain retraction. Simpson grade I was achieved, and there was a good outcome on the postoperative recovery period of the patient, with vision improvement, preservation of olfaction, and no other complications. The minimally invasive interhemispheric approach with a falx window is effective and safe for giant OGM with a good outcome for the patient. The opening in the falx improves the interhemispheric pathway and allows gross total resection with minimal brain retraction and low morbidity.

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