Supraorbital Craniotomy versus Traditional Open Surgical Approaches for Olfactory Groove Meningiomas.

Objective: Olfactory groove meningiomas (OGMs) have largely been addressed through wide surgical exposure techniques including bicoronal or pterional craniotomy. Outcomes comparing these approaches to minimally invasive approaches like the supraorbital craniotomy (SOC) are lacking. Methods: Institutional records were reviewed to include surgically resected OGMs. Variables of interest included tumor volume & height, size of frontal sinus, distance of tumor from posterior table of frontal sinus, surgical approach, extent of resection, recurrence, complications and follow up. Statistical analysis was performed using independent t-test for continuous and Chi-square test for categorical variables. Results: A total of 49 patients were identified. SOC was performed in 17 patients and traditional open approaches were performed in 30 cases. The incidence of complications was 24.5% with CSF leak being the most common. The mean follow up was 35 months. Comparison of SOC with traditional open approaches revealed that tumors in the SOC subgroup had significantly smaller volume (20 cm3 vs 68 cm3; p<0.001), shorter height (2.5 cm vs 3.85 cm; p<0.001) and were more posterior from the frontal sinus as compared to traditional approach (1.5 cm vs 0.85 cm; p=0.003). The length of stay was significantly shorter in SOC subgroup (4.25 days vs 8 days; p=0.02). Conclusion: SOC offers a shorter length of stay as compared to traditional surgical approaches for small to medium sized OGMs with a comparable extent of resection, risk of recurrence and complications. The size of frontal sinus did not appear to be a limiting factor in selecting SOC approach.