Olfactory groove meningiomas – surgical treatment, surgical risks and sense of smell preservation

Authors: M. Dedeciusová 1;  M. Májovský 1;  P. Fundová 2;  V. Beneš 1;  D. Netuka 1
Authors‘ workplace: Neurochirurgická a neuroonkologická klinika 1. LF UK a ÚVN Praha 1;  Klinika otorhinolaryngologie a maxilofaciální chirurgie 3. LF UK a ÚVN Praha 2
Published in: Cesk Slov Neurol N 2018; 81(1): 11-16
Category: Review Article
doi: https://doi.org/10.14735/amcsnn201811


This review summarizes dysfunction of olfaction in patients with olfactory groove meningiomas (OGM). Clinical examination, including pre-operative and post-operative assessment of olfaction, is indispensable for the evaluation of the surgical outcome in patients with OGM. Review of a recent series of OGM documents showed a lack of the olfaction assessment in most of the studies. Psychophysical tests determining olfactory detection, discrimination and identification (e. g. University of Pennsylvania Smell Identification Test [UPSIT], The Single Staircase Odor Detection Threshold Test, Siffin’ Sticks Test) should be used to reveal olfactory dysfunction. Specialized examination techniques such as electro-olfactogram, olfactory evoked potentials and functional magnetic resonance imaging are being used in research. Standard treatment of OGM is a surgical resection. Controversy exists among the authors regarding the selection of a convenient surgical approach. Commonly, the uni-frontal and pterional approaches are being performed. Endoscopic resection, olfactory groove meningiomas, represents an alternative approach yet its indications are still limited. Postoperative olfaction preservation remains a difficult task even today.

Key words:
olfactory groove meningioma – skull base – olfaction – olfactory nerve

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


1. Abbassy M, Woodard TD, Sindwani R et al. An overview of anterior skull base meningiomas and the endoscopic endonasal approach. Otolaryngol Clin North Am 2016; 49(1): 141–152. doi: 10.1016/ j.otc.2015.08.002.

2. Bitter AD, Stavrinou LC, Ntoulias G et al. The role of the pterional approach in the surgical treatment of olfactory groove meningiomas: a 20-year experience. J Neurol Surg B Skull Base 2013; 74(2): 97–102. doi: 10.1055/ s-0033-1333618.

3. Romani R, Lehecka M, Gaal E et al. Lateral supraorbital approach applied to olfactory groove meningiomas: experience with 66 consecutive patients. Neurosurgery 2009; 65(1): 39–52. doi: 10.1227/ 01.NEU.0000346266.69493.88.

4. Durante F. Estirpazione di un tumore endocranico. Arch Atti Social Chir 1886; 2: 252–255.

5. Cushing H, Eisenhardt TL. The olfactory groove meningiomas with primary anosmia. In: Cushing H, Eisenhardt TL (eds). Meningiomas. Springfield: Charles C. Thomas 1938. 250–282.

6. Sameš M, Vachata P, Zolal A et al. Chirurgie baze lební (uvnitř minimonografie video). Cesk Slov Neurol N 2013; 76/ 109(4): 402–424.

7. Netuka D, Masopust V, Belšan T et al. Endoskopické endonazální operace meningeomů baze lební. Cesk Slov Neurol N 2013; 76/ 109(4): 446–452.

8. Toller SV. Assessing the impact of anosmia: review of a questionnaire‘s findings. Chem Senses 1999; 24(6): 705–712.

9. Komotar RJ, Starke RM, Raper DM et al. Endoscopic endonasal versus open transcranial resection of anterior midline skull base meningiomas. World Neurosurg 2012; 77(5–6): 713–724. doi: 10.1016/ j.wneu.2011.08.025.

10. Hentschel SJ, DeMonte F. Olfactory groove meningiomas. Neurosurg Focus 2003; 14(6): e4.

11. Fox D, Khurana VG, Spetzler RF. Olfactory groove/ planum sphenoidale meningiomas. In: Lee JH (ed). Meningiomas: dia­gnosis, treatment, and outcome. London: Springer 2008.

12. Rosen CL, Ammerman JM, Sekhar LN et al. Outcome analysis of preoperative embolization in cranial base surgery. Acta Neurochir (Wien) 2002; 144(11): 1157–1164.

13. Bassiouni H, Asgari S, Stolke D. Olfactory groove meningiomas: functional outcome in a series treated microsurgically. Acta Neurochir (Wien) 2007; 149(2): 109–121.

14. Gazzeri R, Galarza M, Gazzeri G. Giant olfactory groove meningioma: ophthalmological and cognitive outcome after bifrontal microsurgical approach. Acta Neurochir (Wien) 2008; 150(11): 1117–1125. doi: 10.1007/ s00701-008-0142-z.

15. Spektor S, Valarezo J, Fliss DM et al. Olfactory groove meningiomas from neurosurgical and ear, nose, and throat perspectives: approaches, techniques, and outcomes. Neurosurgery 2005; 57 (4 Suppl): 268–280.

16. Nakamura M, Struck M, Roser F et al. Olfactory groove meningiomas: clinical outcome and recurrence rates after tumor removal through the frontolateral and bi­frontal approach. Neurosurgery 2007; 60(5): 844–852.

17. Magerová H, Laczó J, Vyhnálek M et al. Vyšetření čichu a jeho význam pro dia­gnostiku neurodegenerativních onemocnění. Neurol Praxi 2008; 9(1): 30–32.

18. Doty RL. Office procedures for quantitative assessment of olfactory function. Am J Rhinol 2007; 21(4): 460–473.

19. Smith DV. Assessment of patients with taste and smell disorders. Acta Otolaryngol (Suppl) 1988; 458: 129–133.

20. Schaller C, Rohde V, Hassler W. Microsurgical removal of olfactory groove meningiomas via the pterional ap­proach. Skull Base Surg 1994; 4(4): 189–192.

21. Turazzi S, Cristofori L, Gambin R et al. The pterional approach for the microsurgical removal of olfactory groove meningiomas. Neurosurgery 1999; 45(4): 821–825.

22. Pallini R, Fernandez E, Lauretti L et al. Olfactory groove meningioma: report of 99 cases surgicallytreat­ed at the Catholic University School of Medicine, Rome. World Neurosurg 2015; 83(2): 219–231. doi: 10.1016/ j.wneu.2014.11.001.

23. Guduk M, Yener U, Sun HI et al. Pterional and unifrontal approach for the microsurgical resection of olfactory groove meningiomas: experience with a series of 61 consecutive patients. Turk Neurosurg 2017; 27(5): 707–715. doi: 10.5137/ 1019-5149.JTN.17154-16.1.

24. Ciurea AV, Iencean SM, Rizea RE et al. Olfactory groove meningiomas: a retrospective study on 59 surgical cases. Neurosurg Rev 2012; 35(2): 195–202. doi: 10.1007/ s10143-011-0353-2.

25. Jang WY, Jung S, Jung TY et al. Preservation of olfaction in surgery of olfactory groove meningiomas. Clin Neurol Neurosurg 2013; 115(8): 1288–1292. doi: 10.1016/ j.clineuro.2012.12.004.

26. Welge-Luessen A, Temmel A, Quint C et al. Olfactory function in patients with olfactory groove meningioma. J Neurol Neurosurg Psychiatry 2001; 70(2): 218–221.

27. Allison T, Goff WR. Human cerebral evoked responses to odorous stimuli. Electroencephalogr Clin Neurophysiol 1967; 23(6): 558–560.

28. Kobal G, Hummel C. Cerebral chemosensory evoked potentials elicited by chemical stimulation of the human olfactory and respiratory nasal mucosa. Electroencephalogr Clin Neurophysiol 1988; 71(4): 241–250.

29. Sato M, Kodama N, Sasaki T et al. Olfactory evoked potentials: experimental and clinical studies. J Neurosurg 1996; 85(6): 1122–1126.

30. Thirumala PD, Habeych ME, Crammond DJ et al. Neurophysiologic intraoperative monitoring of olfactory and optic nerves. J Clin Neurophysiol 2011; 28(6): 538–542. doi: 10.1097/ WNP.0b013e31823e954e.

31. Lapid H, Hummel T. Recording odor-evoked response potentials at the human olfactory epithelium. Chem Senses 2013; 38(1): 3–17. doi: 10.1093/ chemse/ bjs073.

32. Fournel A, Ferdenzi C, Sezille C et al. Multidimensional representation of odors in the human olfactory cortex. Hum Brain Mapp 2016; 37(6): 2161–2172. doi: 10.1002/ hbm.23164.

33. Berlin HA, Stern ER, Ng J et al. Altered olfactory proces­sing and increased insula activity in patients with obsessive-compulsive disorder: an fMRI study. Psychiatry Res 2017; 262: 15–24. doi: 10.1016/ j.pscychresns.2017.01.012.

34. Yasargil MG. Microneurosurgery I. Stuttgart: Georg Thieme Verlag 1984.

35. Olivecrona H, Urban H. Über Meningeome der Sieb­beinplatte. Brun‘s Beitr Klin Chir 1935; 161: 224–253.

36. Dandy WE. Hirnchirurgie. Leipzig: Johann Ambrosius Barth 1938.

37. Tonnis W. Zur Operation der Meningeome der Siebbeinplatte. Zentralbl Neurochir 1938; 1: 1–7.

38. Morley TP. Tumors of the cranial meninges. In: Youmans JR (ed). Neurological surgery: a comprehensive reference guide to the dia­gnosis and management of neurosurgical problems. Philadelphia: Saunders 1973.

39. MacCarty CS, Piepgras DG, Ebersold MJ. Meningeal tumors of the brain. In: Youmans JR (ed). Neurological surgery: a comprehensive reference guide to the dia­gnosis and management of neurosurgical problems. Philadelphia: Saunders 1982.

40. Ojemann RG. Meningiomas: clinical features and surgical management. In: Wilkins RH, Rengachary SS (eds). Neurosurgery. New York: McGraw-Hil 1985.

41. Adappa ND , Lee JY, Chiu AG et al. Olfactory groove meningioma. Otolaryngol Clin North Am 2011; 44(4): 965–980.

42. Liu JK, Christiano LD, Patel SK et al. Surgical nuances for removal of olfactory groove meningiomas using the endoscopic endonasal transcribriform approach. Neurosurg Focus 2011; 30(5): E3. doi: 10.3171/ 2011.2.FOCUS 116.

43. Tsikoudas A, Martin-Hirsch DP. Olfactory groove meningiomas. Clin Otolaryngol Allied Sci 1999; 24(6): 507–509.

44. Mielke D, Mayfrank L, Psychogios MN et al. The anterior interhemispheric approach: a safe and effective approach to anterior skull base lesions. Acta Neurochir (Wien) 2014; 156(4): 689–696. doi: 10.1007/ s00701-013-1972-x.

45. Obeid F, Al-Mefty O. Recurrence of olfactory groove meningiomas. Neurosurgery 2003; 53(3): 534–542.

46. Knopp U, Sepehrnia A. Preservation of olfaction in bifrontal craniotomies for lesions of the anterior and mid­dle cranial fossa. Laryngorhinootologie 2005; 84(5): 319–322.

47. Schroeder HW. Indications and limitations of the endoscopic endonasal approach for anterior cranial base meningiomas. World Neurosurg 2014; 82 (6 Suppl): S81–S85. doi: 10.1016/ j.wneu.2014.07.030.

48. Liu JK, Hattar E, Eloy JA. Endoscopic endonasal approach for olfactory groove meningiomas: operative technique and nuances. Neurosurg Clin N Am 2015; 26(3): 377–388. doi: 10.1016/ j.nec.2015.03.009.

49. de Almeida JR, Snyderman CH, Gardner PA et al. Nasal morbidity following endoscopic skull base surgery: a prospective cohort study. Head Neck 2011; 33(4): 547–551. doi: 10.1002/ hed.21483.

50. Koutourousiou M, Fernandez-Miranda JC, Wang EWet al. Endoscopic endonasal surgery for olfactory groove meningiomas: outcomes and limitations in 50 patients. Neurosurg Focus 2014; 37(4): E8.

51. Shin M, Kondo K, Saito N. Current status of endoscopic endonasal surgery for skull base meningiomas: review of the literature. Neurol Med Chir (Tokyo) 2015; 55(9): 735–743.

52. Flickinger JC, Kondziolka D, Maitz AH et al. Gamma knife radiosurgery of imaging-dia­gnosed intracranial meningioma. Int J Radiat Oncol Biol Phys 2003; 56(3): 801–806.

53. Lomax NJ, Scheib SG. Quantifying the degree of conformity in radiosurgery treatment planning. Int J Radiat Oncol Biol Phys 2003; 55(5): 1409–1419.

54. Youssef AS, Sampath R, Freeman JL et al. Unilateral endonasal transcribriform approach with septal transposition for olfactory groove meningioma: can olfaction be preserved? Acta Neurochir (Wien) 2016; 158(10): 1965–1972. doi: 10.1007/ s00701-016-2922-1.

55. Herz RS, Eliassen J, Beland S et al. Neuroimaging evidence for the emotional potency of odor-evoked memory. Neuropsychologia 2004; 42(3): 371–378.

55. Moberg PJ, Agrin R, Gur RE et al. Olfactory dysfunction in schizophrenia: a qualitative and quantitative review. Neuropsychopharmacology 1999; 21(3): 325–340.

57. Passagia JG, Chirossel JP, Favre JJ et al. Surgical ap­proaches to the anterior fossa, and preservation of olfaction. Adv Tech Stand Neurosurg 1999; 25: 195–241.

58. Mirimanoff RO, Dosoretz DE, Linggood RM et al. Meningioma: analysis of recurrence and progression fol­lowing neurosurgical resection. J Neurosurg 1985; 62(1): 18–24.

59. Maiuri F, Salzano FA, Motta S et al. Olfactory groove meningioma with paranasal sinus and nasal cavity extension: removal by combined subfrontal and nasal approach. J Craniomaxillofac Surg 1998; 26(5): 314–317.

60. Cardali S, Romano A, Angileri FF et al. Microsurgical anatomic features of the olfactory nerve: relevance to olfaction preservation in the pterional approach. Neurosurgery 2005; 57 (1 Suppl): 17–21.

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