Dr. Schwartz Reports on Success of Keyhole Approach for Olfactory Groove Meningioma

Dr. Theodore Schwartz, Vice Chair for Clinical Research and David and Ursel Barnes Professor in Minimally Invasive Surgery, recently published a paper detailing the use of minimally invasive surgery (MIS) to treat olfactory groove meningiomas (OGMs). Dr. Schwartz and his co-authors determined that an eyebrow incision keyhole craniotomy with endoscopic assistance was a safe and effective alternative to open surgery for OGM.

In a traditional open craniotomy for OGM, the neurosurgeon removes a section of the skull to gain access to the brain, then cuts through brain tissue to reach the tumor. The procedure is effective, but open surgery carries a higher level of risk than MIS alternatives. In this minimally invasive keyhole approach, the neurosurgeon makes an incision above the eyebrow for access, then uses an endoscopic tool to remove the meningioma. Patients who have minimally invasive brain surgery have less risk of side effects, less pain, and faster recovery times. The new study shows that they have outcomes comparable to patients who have open surgery.

For this retrospective study, Dr. Schwartz and his team identified fifteen patients with Grade I meningiomas who had been treated with the minimally invasive keyhole approach. All the patients were satisfied with their cosmetic result at the three-month follow up. At a mean follow-up of 32.2 months, no patients required further craniotomy to treat the meningioma.

The study concludes that an eyebrow incision supraorbital keyhole craniotomy with endoscopic assistance is a safe and effective approach for patients with olfactory groove meningiomas. Tumor control rates are similar to more invasive open approaches and better than the endonasal approach. Rates of frontal lobe injury, CSF leak, and anosmia are comparatively low.

Read the abstract of the paper here

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