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Candy NG, Hinder D, Jukes AK, Wormald PJ, Psaltis AJ. Olfaction preservation in olfactory groove meningiomas: a systematic review. Neurosurg Rev 2023; 46:186. [PMID: 37500988 PMCID: PMC10374754 DOI: 10.1007/s10143-023-02096-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/08/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023]
Abstract
Olfactory groove meningiomas (OGM) are a skull base neoplasm that represents between 8 and 13% of all intracranial meningiomas. Approach selection focuses on achieving frontal lobe decompression, gross total resection and vision preservation. Recently, there has been a focus on olfaction and considering its preservation as a quality-of-life outcome measure. An electronic search of the databases Medline, Scopus, Embase, Web of Science and Cochrane library databases was performed and data extracted according 2020 Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) statement. Six articles were selected for inclusion mainly based due to reporting quantitative outcomes for olfaction assessed by a smell identification test (e.g. sniffin' sticks). Objective olfaction preservation can be achieved with a variety of surgical approaches. More research which includes objective assessment of olfactory function and ideally as well QoL outcome measures is needed to further optimize the treatment pathways in OGM patients.
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Affiliation(s)
- Nicholas G Candy
- Department of Surgery Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Research, Woodville South, Adelaide, Australia.
| | - Dominik Hinder
- Department of Surgery Otorhinolaryngology Head and Neck Surgery, Queen Elizabeth Hospital, Adelaide, SA, Australia
| | - Alistair K Jukes
- Department of Neurosurgery, Royal Adelaide Hospital, Adelaide, Australia
| | - Peter-John Wormald
- Department of Surgery Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Research, Woodville South, Adelaide, Australia
| | - Alkis J Psaltis
- Department of Surgery Otolaryngology, Head and Neck Surgery, The University of Adelaide, Basil Hetzel Institute for Translational Research, Woodville South, Adelaide, Australia
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Midline Skull Base Meningiomas: Transcranial and Endonasal Perspectives. Cancers (Basel) 2022; 14:cancers14122878. [PMID: 35740543 PMCID: PMC9220797 DOI: 10.3390/cancers14122878] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/25/2022] [Accepted: 06/03/2022] [Indexed: 12/07/2022] Open
Abstract
Simple Summary Skull base meningiomas have always represented a challenge for neurosurgeons. Despite their histological nature, they may be associated with unfavorable outcomes due to their deep-seated location and the surrounding neurovascular structures. Over time, several corridors have been proposed, each one carrying its own pros and cons. During the last decades, the endoscopic endonasal route has been asserted among the classic routes for a growing number of midline and paramedian lesions. Therefore, the aim of our paper is to present a comprehensive review of the indications and techniques for the management of skull base meningiomas, emphasizing the ambivalent and complementary role of the low and high routes. Abstract Skull base meningiomas have always represented a challenge for neurosurgeons. Despite their histological nature, they may be associated with unfavorable outcomes due to their deep-seated location and the surrounding neurovascular structures. The state of the art of skull base meningiomas accounts for both transcranial, or high, and endonasal, or low, routes. A comprehensive review of the pertinent literature was performed to address the surgical strategies and outcomes of skull base meningioma patients treated through a transcranial approach, an endoscopic endonasal approach (EEA), or both. Three databases (PubMed, Ovid Medline, and Ovid Embase) have been searched. The review of the literature provided 328 papers reporting the surgical, oncological, and clinical results of different approaches for the treatment of skull base meningiomas. The most suitable surgical corridors for olfactory groove, tuberculum sellae, clival and petroclival and cavernous sinus meningiomas have been analyzed. The EEA was proven to be associated with a lower extent of resection rates and better clinical outcomes compared with transcranial corridors, offering the possibility of achieving the so-called maximal safe resection.
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Bunevicius A, Pikis S, Anand RK, Nabeel AM, Reda WA, Tawadros SR, Abdelkarim K, El-Shehaby AMN, Emad RM, Chytka T, Liscak R, Caceres MP, Mathieu D, Lee CC, Yang HC, Picozzi P, Franzini A, Attuati L, Speckter H, Olivo J, Patel S, Cifarelli CP, Cifarelli DT, Hack JD, Strickland BA, Zada G, Chang EL, Fakhoury KR, Rusthoven CG, Warnick RE, Sheehan J. Stereotactic radiosurgery for clinoid meningiomas: a multi-institutional study. Acta Neurochir (Wien) 2021; 163:2861-2869. [PMID: 34427769 DOI: 10.1007/s00701-021-04972-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/12/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Resection of clinoid meningiomas can be associated with significant morbidity. Experience with stereotactic radiosurgery (SRS) for clinoid meningiomas remains limited. We studied the safety and effectiveness of SRS for clinoid meningiomas. METHODS From twelve institutions participating in the International Radiosurgery Research Foundation, we pooled patients treated with SRS for radiologically suspected or histologically confirmed WHO grade I clinoid meningiomas. RESULTS Two hundred seven patients (median age: 56 years) underwent SRS for clinoid meningiomas. Median treatment volume was 8.02 cm3, and 87% of tumors were immediately adjacent to the optic apparatus. The median tumor prescription dose was 12 Gy, and the median maximal dose to the anterior optic apparatus was 8.5 Gy. During a median post-SRS imaging follow-up of 51.1 months, 7% of patients experienced tumor progression. Greater margin SRS dose (HR = 0.700, p = 0.007) and pre-SRS radiotherapy (HR = 0.004, p < 0.001) were independent predictors of better tumor control. During median visual follow-up of 48 months, visual function declined in 8% of patients. Pre-SRS visual deficit (HR = 2.938, p = 0.048) and maximal radiation dose to the optic apparatus of ≥ 10 Gy (HR = 11.297, p = 0.02) independently predicted greater risk of post-SRS visual decline. Four patients experienced new post-SRS cranial nerve V neuropathy. CONCLUSIONS SRS allows durable control of clinoid meningiomas and visual preservation in the majority of patients. Greater radiosurgical prescription dose is associated with better tumor control. Radiation dose to the optic apparatus of ≥ 10 Gy and visual impairment before the SRS increase risk of visual deterioration.
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Affiliation(s)
- Adomas Bunevicius
- Department of Neurosurgery, University of Virginia, Charlottesville, VA, 22908, USA
| | - Stylianos Pikis
- Department of Neurosurgery, University of Virginia, Charlottesville, VA, 22908, USA
| | | | - Ahmed M Nabeel
- Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt
- Neurosurgery Department, Benha University, Qalubya, Egypt
| | - Wael A Reda
- Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt
- Neurosurgery Department, Ain Shams University, Cairo, Egypt
| | - Sameh R Tawadros
- Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt
- Neurosurgery Department, Ain Shams University, Cairo, Egypt
| | - Khaled Abdelkarim
- Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt
- Neurosurgery Department, Ain Shams University, Cairo, Egypt
| | - Amr M N El-Shehaby
- Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt
- Neurosurgery Department, Ain Shams University, Cairo, Egypt
| | - Reem M Emad
- Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt
- National Cancer Institute, Cairo, Egypt
| | - Tomas Chytka
- Stereotactic and Radiation Neurosurgery Department, Na Homolce Hospital, Prague, Czech Republic
| | - Roman Liscak
- Stereotactic and Radiation Neurosurgery Department, Na Homolce Hospital, Prague, Czech Republic
| | - Marco Perez Caceres
- Department of Neurosurgery, Université de Sherbrooke, Centre de Recherche du CHUS, Sherbrooke, Canada
| | - David Mathieu
- Department of Neurosurgery, Université de Sherbrooke, Centre de Recherche du CHUS, Sherbrooke, Canada
| | - Cheng-Chia Lee
- Department of Neurosurgery, Neurological Institute, Taipei Veteran General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Huai-Che Yang
- Department of Neurosurgery, Neurological Institute, Taipei Veteran General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Piero Picozzi
- Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rome, Italy
| | - Andrea Franzini
- Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rome, Italy
| | - Luca Attuati
- Department of Neurosurgery, Humanitas Clinical and Research Center - IRCCS, Rome, Italy
| | - Herwin Speckter
- Centro Gamma Knife Dominicano and Radiology Department, CEDIMAT, Santo Domingo, Dominican Republic
| | - Jeremy Olivo
- Centro Gamma Knife Dominicano and Radiology Department, CEDIMAT, Santo Domingo, Dominican Republic
| | - Samir Patel
- Division of Radiation Oncology, Department of Oncology, University of Alberta, Edmonton, Canada
| | - Christopher P Cifarelli
- Department of Neurosurgery, West Virginia University, Morgantown, USA
- Department of Radiation Oncology, West Virginia University, Morgantown, USA
| | | | - Joshua D Hack
- Department of Radiation Oncology, West Virginia University, Morgantown, USA
| | - Ben A Strickland
- Department of Neurosurgery, University of Southern California, Los Angeles, USA
| | - Gabriel Zada
- Department of Neurosurgery, University of Southern California, Los Angeles, USA
| | - Eric L Chang
- Department of Radiation Oncology, University of Southern California, Los Angeles, USA
| | - Kareem R Fakhoury
- Department of Radiation Oncology, University of Colorado, Boulder, USA
| | - Chad G Rusthoven
- Department of Radiation Oncology, University of Colorado, Boulder, USA
| | | | - Jason Sheehan
- Department of Neurosurgery, University of Virginia, Charlottesville, VA, 22908, USA.
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