Exoscopic resection of giant olfactory groove meningioma

Francesco Calvanese; Anna Maria Auricchio; Martin Lehecka

doi:10.3171/2023.10.FOCVID23125

Exoscopic resection of giant olfactory groove meningioma

Neurosurg Focus Video. 2024 Jan 1;10(1):V6. doi: 10.3171/2023.10.FOCVID23125. eCollection 2024 Jan.

Authors

Francesco Calvanese¹, Anna Maria Auricchio^{1

2}, Martin Lehecka¹

Affiliations

¹ Department of Neurosurgery, Helsinki University Hospital and University of Helsinki, Finland; and.
² Department of Neurosurgery, University Hospital Foundation A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy.

Abstract

Olfactory groove meningiomas represent 8%-13% of all intracranial meningiomas. Gross-total resection for large (4-6 cm) and giant (> 6 cm) cases remains challenging due to their relationship with critical neurovascular structures and extensive frontal lobe edema. A variety of transcranial and endoscopic approaches have been described. This 2D operative video shows the use of a digital 3D exoscope in the removal of a giant olfactory groove meningioma through a lateral supraorbital approach in a 57-year-old woman with visual impairment and apathy. The exoscope provides a very good angulated view of the subfrontal area on both sides of the anterior cranial fossa even through a small craniotomy. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23125.

Keywords: exoscope; foot pedal; lateral supraorbital approach; olfactory groove meningioma; translational and angular movements.