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Acta Neurochirurgica

, Volume 158, Issue 10, pp 1965–1972 | Cite as

Unilateral endonasal transcribriform approach with septal transposition for olfactory groove meningioma: can olfaction be preserved?

  • A. Samy YoussefEmail author
  • Raghuram Sampath
  • Jacob L. Freeman
  • Jameson K. Mattingly
  • Vijay R. Ramakrishnan
Clinical Article - Neurosurgical Techniques

Abstract

Background

Loss of olfaction has been considered inevitable in endoscopic endonasal resection of olfactory groove meningiomas. Olfaction preservation may be feasible through an endonasal unilateral transcribriform approach, with the option for expansion using septal transposition and contralateral preservation of the olfactory apparatus.

Methods

An expanded unilateral endonasal transcribriform approach with septal transposition was performed in five cadaver heads. The approach was applied in a surgical case of a 24 × 26-mm olfactory groove meningioma originating from the right cribriform plate with partially intact olfaction.

Results

The surgical approach offered adequate exposure to the anterior skull base bilaterally. The nasal/septal mucosa was preserved on the contralateral side. Gross total resection of the meningioma was achieved with the successful preservation of the contralateral olfactory apparatus and preoperative olfaction. Six months later, the left nasal cavity showed no disruption of the mucosal lining and the right side was at the appropriate stage of healing for a harvested nasoseptal flap. One year later, the preoperative olfactory function was intact and favorably viewed by the patient. Objective testing of olfaction showed microsomia.

Conclusions

Olfaction preservation may be feasible in the endoscopic endonasal resection of a unilateral olfactory groove meningioma through a unilateral transcribriform approach with septal transposition and preservation of the contralateral olfactory apparatus.

Keywords

Olfactory groove Meningioma Olfaction preservation Septal dislocation Transcribriform 

Notes

Acknowledgments

We would like to thank Zach Folzenlogen, MD, for assistance with illustrations in this manuscript.

Compliance with ethical standards

Funding

No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent

For this type of study formal consent is not required.

Supplementary material

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(MP4 40995 kb)

References

  1. 1.
    Banu MA, Mehta A, Ottenhausen M, Fraser JF, Patel KS, Szentirmai O, Anand VK, Tsiouris AJ, Schwartz TH (2015) Endoscope-assisted endonasal versus supraorbital keyhole resection of olfactory groove meningiomas: comparison and combination of 2 minimally invasive approaches. J Neurosurg 14:1–16Google Scholar
  2. 2.
    Brand G, Jacquot L (2001) Quality of odor and olfactory lateralization processes in humans. Neurosci Lett 316(2):91–94CrossRefPubMedGoogle Scholar
  3. 3.
    De Almeida JR, Carvalho F, Vaz Guimaraes Filho F, Kiehl TR, Koutourousiou M, Su S, Vescan AD, Witterick IJ, Zadeh G, Wang EW, Fernandez-Miranda JC, Gardner PA, Gentili F, Snyderman CH (2015) Comparison of endoscopic endonasal and bifrontal craniotomy approaches for olfactory groove meningiomas: a matched pair analysis of outcomes and frontal lobe changes on MRI. J Clin Neurosci 22(11):1733–1741CrossRefPubMedGoogle Scholar
  4. 4.
    Doty RL, Shaman P, Kimmelman CP, Dann MS (1984) University of Pennsylvania smell identification test: a rapid quantitative olfactory function test for the clinic. Laryngoscope 94(2 pt 1):176–178CrossRefPubMedGoogle Scholar
  5. 5.
    Fulbright RK, Skudlarski P, Lacadie CM, Warrenburg S, Bowers AA, Gore JC, Wexler BE (1998) Functional MR imaging of regional brain responses to pleasant and unpleasant odors. AJNR Am J Neuroradiol 19(9):1721–1726PubMedGoogle Scholar
  6. 6.
    Herz RS, McCall C, Cahill L (1999) Hemispheric lateralization in the processing of odor pleasantness versus odor names. Chem Senses 24(6):691–695CrossRefPubMedGoogle Scholar
  7. 7.
    Jang WY, Jung S, Jung TY, Moon KS, Kim IY (2013) Preservation of olfaction in surgery of olfactory groove meningiomas. Clin Neurol Neurosurg 115(8):1288–1292CrossRefPubMedGoogle Scholar
  8. 8.
    Kettenmann B, Hummel C, Stefan H, Kobal G (1996) Multichannel magnetoencephalographical recordings: separation of cortical responses to different chemical stimulation in man. Electroencephalogr Clin Neurophysiol Suppl 46:271–274PubMedGoogle Scholar
  9. 9.
    Kobal G, Hummel T, Van Toller S (1992) Differences in human chemosensory evoked potentials to olfactory and somatosensory chemical stimuli presented to the left and right nostrils. Chem Senses 17:233–244CrossRefGoogle Scholar
  10. 10.
    Koutourousiou M, Fernandez-Miranda JC, Wang EW, Snyderman CH, Gardner PA (2014) Endoscopic endonasal surgery for olfactory groove meningiomas: outcomes and limitations in 50 patients. Neurosurg Focus 37(4):E8CrossRefPubMedGoogle Scholar
  11. 11.
    Liu JK, Hattar E, Eloy JA (2015) Endoscopic endonasal approach for olfactory groove meningiomas: operative technique and nuances. Neurosurg Clin N Am 26(3):377–388CrossRefPubMedGoogle Scholar
  12. 12.
    Ramakrishnan VR, Suh JD, Chiu AG, Palmer JN (2011) Septal dislocation for endoscopic access of the anterolateral maxillary sinus and infratemporal fossa. Am J Rhinol Allergy 25(2):128–130CrossRefPubMedGoogle Scholar
  13. 13.
    Rosen MR, Rabinowitz MR, Farrell CJ, Schaberg MR, Evans JJ (2014) Septal transposition: a novel technique for preservation of the nasal septum during endoscopic endonasal resection of olfactory groove meningiomas. Neurosurg Focus 37(4):E6CrossRefPubMedGoogle Scholar
  14. 14.
    Schroeder HW (2015) Indications and limitations of the endoscopic endonasal approach for anterior cranial base meningiomas. World Neurosurg 82(6 Suppl):S81–S85Google Scholar
  15. 15.
    Schwartz TH (2014) Should endoscopic endonasal surgery be used in the treatment of olfactory groove meningiomas? Neurosurg Focus 37(4):E9CrossRefPubMedGoogle Scholar
  16. 16.
    Sobel N, Prabhakaran V, Desmond JE, Glover GH, Goode RL, Sullivan EV, Gabrieli JD (1998) Sniffing and smelling: separate subsystems in human olfactory cortex. Nature 392:282–286CrossRefPubMedGoogle Scholar
  17. 17.
    Youssem DM, Williams SCR, Howard RO, Andrew C, Simmons A, Allin M, Geckle RJ, Suskind D, Bullmore ET, Brammer MJ, Doty RL (1997) Functional MR imaging during odor stimulation: preliminary data. Radiology 204:833–838CrossRefGoogle Scholar
  18. 18.
    Zatorre R, Jones-Gotman M, Evans A, Meyer E (1992) Functional localization of human olfactory cortex with positron emission tomography. Soc Neurosci Abstr 18:933Google Scholar
  19. 19.
    Zuco GM, Tressoldi PE (1988) Hemispheric differences in odour recognition. Cortex 25:607–615CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • A. Samy Youssef
    • 1
    • 2
    Email author
  • Raghuram Sampath
    • 1
  • Jacob L. Freeman
    • 1
  • Jameson K. Mattingly
    • 3
  • Vijay R. Ramakrishnan
    • 3
  1. 1.School of Medicine, Department of NeurosurgeryUniversity of Colorado DenverDenverUSA
  2. 2.Departments of Neurosurgery & OtolaryngologyUniversity of Colorado School of MedicineAuroraUSA
  3. 3.School of Medicine, Department of OtolaryngologyUniversity of Colorado DenverDenverUSA

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