Fronto-Basal Interhemispheric Approach for Olfactory Groove Meningiomas Excision; Outcome of Surgery

Background: Olfactory groove meningiomas (OGMs) are arachnoid cell neoplasms affecting the fronto-ethmoidal suture and lamina cribrosa. OGMs, which appear in the midline of the anterior fossa, typically impinge on the frontal lobes via mass effect. Objective: This work aimed to evaluate the surgical efficacy, clinical and functional outcomes and postoperative complications of frontobasal interhemispheric approach (FBIA) for OGMs. Patients and Methods: This prospective clinical trial was carried on 20 patients who had positive images with OGM and were managed in the Department of Neurosurgery, Tanta University Hospitals. All patients underwent ophthalmological and olfactory function assessments and cognitive function and memory assessment with the montreal cognitive assessment (MoCA). Results: During the follow-up, headache, cognitive behavioral changes and seizures were significantly improved compared to preoperative symptoms (P=0.012, 0.019, 0.029 respectively). MoCA score was significantly improved during the follow-up compared to the preoperative score (P<0.001). The GCS was significantly improved during the follow-up (P=0.045), Additionally, diabetes insipidus not occurred during the follow-up duration. there was a significant improvement regarding the edema, and hematoma (P<0.001, <0.001). Preservation olfactory function was significantly higher in <4 cm tumor size compared to >4 cm tumor size. Conclusions: Given its familiarity, FBIA is a safe and workable technique to handling massive OGMs. Most promising is the acceptable functional outcome improvement we saw in the managed group of patients. When it comes to ensuring patient outcomes, one must constantly be adaptable. We may underline that the technique is a protection for frontal lobe and olfactory nerve function.