Gross Total Resection of a Huge Olfactory Groove Meningioma via Bicoronal Subfrontal Approach Without Orbital Osteotomy: A Case Report
Novelty in Biomedicine,
Vol. 14 No. 3 (2026),
25 August 2026
,
Page 157-161
https://doi.org/10.22037/nbm.v14i3.52028
Abstract
Background: Olfactory groove meningiomas (OGMs) are slow-growing, relatively rare and benign brain tumors that account for about 4–13% of all intracranial meningiomas. They can be demonstrated with variety of symptoms but often present with anosmia, headaches, visual disturbances, and personality changes. Surgical resection is the treatment of choice, with various approaches described. We present a case of huge OGM that resected totally through a bilateral subfrontal approach without orbital osteotomy.
Cases Report: A 62-year-old man with chronic headache, anosmia, and progressive personality changes over five years presented with an episode of generalized seizure and was found to have a large anterior cranial fossa mass on CT (Computed Tomography) and MRI (Magnetic Resonance Imaging), compatible with an olfactory groove meningioma. The patient underwent a bicoronal subfrontal craniotomy without orbital osteotomies. Intraoperative steps included cranialization of the frontal sinus, devascularization of the tumor, and careful extracapsular dissection under microscopic guidance. Gross total resection (Simpson Grade I) was achieved without intraoperative complications. The optic chiasm and anterior cerebral arteries were preserved. Postoperative imaging confirmed complete resection, and the patient’s neurological symptoms improved significantly.
Conclusion: The bicoronal subfrontal approach provides adequate exposure and allows safe gross total resection of large OGMs without the need for orbital osteotomies in this patient. This technique minimizes operative time and blood loss along with preserving normal anatomy of orbital rim and orbital roof while achieving favorable surgical and clinical outcomes in our case. Hence further studies are needed to assess applicability of these findings for resection of large olfactory groove meningioma without orbital osteotomy.
- Olfactory groove meningioma
- Subfrontal craniotomy
- Orbital osteotomy
- Gross total resection
- Skull base surgery
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References
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