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Giant olfactory groove meningioma: ophthalmological and cognitive outcome after bifrontal microsurgical approach

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Abstract

Object

Olfactory groove meningiomas arise in the midline along the dura of the cribriform plate and may reach a large size before producing symptoms. We conducted a retrospective study of patients with these lesions focused on pre- and post-operative investigations for ophthalmological, personality and cognitive disturbances.

Methods

The authors reviewed 36 patients with giant olfactory groove meningiomas surgically treated via a bifrontal approach. Ophthalmological evaluation included visual acuity, fundoscopy and visual fields while psychological evaluation included a Mini-Mental State Examination. Data was collected before, 1 and 12 months after surgery. Formal pre- and post-operative ophthalmological examinations discovered visual deficits in 55.5% of the patients. Within the first month after surgery, improvement of visual acuity and of visual field deficits was observed. In post-operative neuropsychological testing, higher mental functions showed improvement. The most frequent post-operative complication was persistent rhinorrhoea in two patients.

Conclusions

Results at longest follow up indicate that cognitive changes and visual deficits will improve in patients with giant olfactory groove meningiomas after a bifrontal approach, without additional neurological deficits.

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Authors and Affiliations

  1. Department of Neurosurgery, San Giovanni Addolorata Hospital, Via O. Tommasini 13, 00162, Rome, Italy

    Roberto Gazzeri & Marcelo Galarza

  2. Department of Neurosurgery, San Filippo Neri Hospital, Rome, Italy

    Giovanni Gazzeri

Authors
  1. Roberto Gazzeri
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  2. Marcelo Galarza
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  3. Giovanni Gazzeri
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Correspondence to Roberto Gazzeri.

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Comment

The patients described here are remarkable for several reasons: the size of the tumours that have developed (often over many years), the fact that removal even at a late stage produces an improvement in function, and the relatively good prognosis after operation. This paper nicely describes this neurosurgical success story; the authors are to be particularly commended for including a routine assessment of cognitive function.

Lindsay Wilson

University of Stirling

Comment

The authors present their visual and cognitive results for the bifrontal approach (except one patient) to giant olfactory groove meningiomas. The 36 patients were accrued over a 14 year period ending in 2004. The primary message of the article is that visual and cognitive dysfunction does improve after surgery and that the majority of the improvement occurs within the first month. In addition, chronicity of visual deficits predicts a worse visual outcome. This is a very reasonably written article and one that adds to the literature.

John A. Jane, Jr.

University of Virginia

The Author’s didn’t receive any financial support in conjunction with the generation of their submission.

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Gazzeri, R., Galarza, M. & Gazzeri, G. Giant olfactory groove meningioma: ophthalmological and cognitive outcome after bifrontal microsurgical approach. Acta Neurochir (Wien) 150, 1117–1126 (2008). https://doi.org/10.1007/s00701-008-0142-z

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