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Acta Neurochirurgica

Published in:

01-09-2021 | Meningioma | How I Do it - Tumor - Meningioma

Olfactory nerve sparing technique for anterior skull base meningiomas: how I do it

Authors: Paolo Ferroli, Francesco Restelli, Morgan Broggi

Published in: Acta Neurochirurgica | Issue 9/2021

Abstract

Background

Olfactory function preservation is a desirable objective in anterior skull base (ASB) surgery. The “infracerebral-supraolfactory nerve” corridor is presented.

Method

The technique for preserving the olfactory nerves (OlfNs) in anterior ASB meningioma removal involves the following points: deep knowledge of the ASB vascular and meningeal anatomy, precise preoperative planning, wide and sharp dissection of the OlfNs away from the frontal lobes, gravity-aided frontal lobe retraction, Gelfoam-assisted hemostasis on nervous structures, and access to the lesion through an infracerebral-supraolfactory nerve corridor.

Conclusions

This technique may be a valid option for patients affected by anterior skull base meningiomas with intact preoperative olfactory function.

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Acerbi F, Broggi M, Broggi G, Ferroli P (2015) What is the best timing for fluorescein injection during surgical removal of high-grade gliomas? Acta Neurochir (Wien) 157:1377–1378. https://doi.org/10.1007/s00701-015-2455-zCrossRef

Cardali S, Romano A, Angileri FF, Conti A, La Torre D, De Divitiis O, D’Avella D, Tschabitscher M, Tomasello F (2005) Microsurgical anatomic features of the olfactory nerve: Relevance to olfaction preservation in the pterional approach. Neurosurgery 57:17–21. https://doi.org/10.1227/01.NEU.0000144844.72403.7BCrossRefPubMed

Cömert A, Uǧur HÇ, Kahiloǧullar G, Cömert E, Elhan A, Tekdemir I (2011) Microsurgical anatomy for intraoperative preservation of the olfactory bulb and tract. J Craniofac Surg 22:1080–1082. https://doi.org/10.1097/SCS.0b013e3182139884CrossRefPubMed

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 94:176–178. https://doi.org/10.1288/00005537-198402000-00004CrossRefPubMed

Favre JJ, Chaffanjon P, Passagia JG, Chirossel JP (1995) Blood supply of the olfactory nerve-meningeal relationships and surgical relevance. Surg Radiol Anat 17:133–138. https://doi.org/10.1007/BF01627573CrossRefPubMed

Hernesniemi J, Ishii K, Niemelä M, Smrcka M, Kivipelto L, Fujiki M, Shen H (2005) Lateral supraorbital approach as an alternative to the classical pterional approach. Acta Neurochir Suppl 94:17–21. https://doi.org/10.1007/3-211-27911-3_4CrossRefPubMed

López-Elizalde R, Campero A, Sánchez-Delgadillo T, Lemus-Rodríguez Y, López-González MI, Godínez-Rubí M (2018) Anatomy of the olfactory nerve: a comprehensive review with cadaveric dissection. Clin Anat 31:109–117. https://doi.org/10.1002/ca.23003CrossRefPubMed

Perneczy A, Reisch R (2008) Keyhole approache sin Neurosurgery - Volume I Concept and Surgical Technique. Springer Wien New York

Schroeder HWS (2014) Indications and limitations of the endoscopic endonasal approach for anterior cranial base meningiomas. World Neurosurg 82:S81–S85. https://doi.org/10.1016/j.wneu.2014.07.030CrossRefPubMed

10.

Spetzler RF, Sanai N (2012) The quiet revolution: retractorless surgery for complex vascular and skull base lesions-clinical article. J Neurosurg 116:291–300. https://doi.org/10.3171/2011.8.JNS101896CrossRefPubMed

11.

Wang S, Zheng H-P, Zhang X, Zhang F-H, Jing J-J, Wang R-M (2008) Microanatomy and surgical relevance of the olfactory cistern. Microsurgery 28:65–70. https://doi.org/10.1002/micrCrossRefPubMed

12.

Yasargil MG, Reichman MV, Kubik S (1987) Preservation of the frontotemporal branch of the facial nerve using the interfascial temporalis flap for pterional craniotomy. Technical article. J Neurosurg 67:463–466. https://doi.org/10.3171/jns.1987.67.3.0463CrossRefPubMed

Title: Olfactory nerve sparing technique for anterior skull base meningiomas: how I do it
Authors: Paolo Ferroli
Francesco Restelli
Morgan Broggi
Publication date: 01-09-2021
Publisher: Springer Vienna
Keywords: Meningioma
Meningioma
Published in: Acta Neurochirurgica / Issue 9/2021
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-021-04929-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Olfactory nerve sparing technique for anterior skull base meningiomas: how I do it

Abstract

Background

Method

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Method

Conclusions

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