关键词: Olfaction Olfactory groove meningiomas Surgical approach

Mesh : Adult Age Factors Aged Brain Edema / complications epidemiology Female Humans Image Processing, Computer-Assisted Magnetic Resonance Imaging Male Meningioma / pathology surgery Middle Aged Neurosurgical Procedures Olfaction Disorders / epidemiology etiology Olfactory Nerve / surgery Olfactory Pathways / surgery Postoperative Complications / epidemiology Prognosis Sex Factors Smell / physiology Tomography, X-Ray Computed Treatment Outcome

来  源:   DOI:10.1016/j.clineuro.2012.12.004   PDF(Sci-hub)

Abstract:
BACKGROUND: Olfaction is commonly considered as secondary among the sensory functions, perhaps reflecting a lack of interest in sparing olfaction after surgery for the olfactory groove meningiomas (OGM). However, considering the repercussions of olfaction for the quality of life, the assessment of post-operative olfaction should be necessary. We retrospectively reviewed the olfactory outcome in patients with OGM and investigated the factors associated with sparing the post-operative olfaction.
METHODS: Between 1993 and 2012, 40 patients with OGM underwent surgical resection and estimated the olfactory function using the Korean version of \"Sniffin\'Sticks\" test (KVSS). Variable factors, such as tumor size, degree of preoperative edema, tumor consistency, preoperative olfactory function, surgical approaches, patient\'s age, and gender were analyzed with attention to the post-operative olfactory function.
RESULTS: Anatomical and functional preservation of olfactory structures were achieved in 26 patients (65%) and 22 patients (55%), respectively. Among the variable factors, size of tumor was significant related to the preservation of post-operative olfaction. (78.6% in size<4 cm and 42.3% in size>4 cm, p=0.035). Sparing the olfaction was significantly better in patients without preoperative olfactory dysfunction (84.6%) compared with ones with preoperative olfactory dysfunction (40.7%, p=0.016). The frontolateral approach achieved much more excellent post-operative olfactory function (71.4%) than the bifrontal approach (36.8%, p=0.032).
CONCLUSIONS: If the tumor was smaller than 4 cm and the patients did not present olfactory dysfunction preoperatively, the possibility of sparing the post-operative olfaction was high. Among the variable surgical approaches, frontolateral route may be preferable sparing the post-operative olfaction.
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