Anterior Interhemispheric Approach for Olfactory Groove Meningioma
Abstract: To evaluate the
surgical technique with bifrontal interhemispheric approach for total removal
of tumor in olfactory groove meningioma (OGM).
Methods: This study described a case of a 38-year-old woman with
bilateral blindness, anosmia, and behaviour changes. Imaging studies show a
tumor mass in midfrontal base. Surgery using a bifrontal interhemispheric
approach was performed and total removal was achieved and postoperative
computed tomography (CT) scan was performed to confirm the result. Histopathological
findings established a diagnosis of meningioma.
Results: A coronal skin incision behind the hairline was utilized. The
scalp was elevated, taking care to reserve the vascularized pericranium medial
to the linea temporalis of each side, and preserving the 2 supraorbital nerves.
Eight burr holes were used, with the two initial holes made on each side of the
orbitotemporal region, and the other four holes at the midline. A bifrontal
craniotomy was performed. The tumor was first detached from its attachment with
bipolar cautery and debulked. During this step, the main tumor feeder arteries
from the anterior and posterior ethmoidal artery were interrupted, and the
tumor devascularized. Total tumor removal through surgical intervention was
achieved and confirmed by head CT-scan postoperatively.
Conclusions: This case report supports the suitability of the bifrontal
interhemispheric approach for OGM resection with additional radiation therapy.
Author: Hidayat, Agung Budi
Sutiono, Ahmad Faried, Muhammad Zafrullah Arifin
Journal Code: jpkedokterangg160127