Study on microsurgical treatment by unilateral subfrontal approach in 16 patients with large olfactory groove meningiomas / 中国医师进修杂志

Objective To study the method and therapeutic effect of microsurgical treatment by unilateral subfrontal approach in patients with large olfactory groove meningiomas. Methods The clinical data of 16 patients with large olfactory groove meningiomas who had underwent microsurgical treatment by unilateral subfrontal approach from January 2010 to December 2017 were analyzed retrospectively. Results Total removal of tumor (Simpson Ⅰ and Ⅱ grade) was achieved in 14 cases and subtotal removal of the tumor (Simpson Ⅲ) was in 2 cases. No patient died from the microsurgery. The treatment effect was satisfactory in all patients during the follow- up. Conclusions The microsurgical treatment by unilateral subfrontal approach in patients with large olfactory groove meningiomas conforms to the concept of minimal invasive surgery, which provides enough surgical space, and the effect of surgery is satisfactory. So the approach is a good choice for the removal of large olfactory groove meningiomas.

Treatment of Olfactory Groove Meningioma through a Unilateral Subfrontal Approach / 中国医科大学学报

Objective To compare the operative results of removing large olfactory groove meningiomas(diameter≥3 cm)using either a unilat?eral or bilateral subfrontal approach ,and to determine whether there is an advantage in the unilateral approach. Methods Sixty?nine cases of large olfactory groove meningioma,treated in our department,by either a unilateral or bilateral subfrontal approach microsurgery were retrospec?tively reviewed. Removal grading,post?operative complications,and other clinical indices were evaluated. Results Total resection(Simpson Ⅰ or Ⅱ)was achieved in all the cases. There were lesser complications with use of the unilateral subfrontal approach. Conclusion Patients with ol?factory groove meningioma have a good prognosis when a unilateral subfrontal approach is used for surgery.

Management of large pituitary adenoma:Transorbital subfrontal approach operations associated with postoperative X-knife therapy / 中国微创外科杂志

Objective To assess the technique and the safety of radical resection for large pituitary adenoma. Methods Unilateral transorbital subfrontal approach operations were employed for treating 14 cases of large or giant pituitary adenomas. Tumors, at least the suprasellar extension of them, were removed as thoroughly as possible in surgery. Then the X-knife was administered for intrasellar residual lesions 1.5～3.5 months after the surgery. Results Total removal of tumors was achieved in 4 patients, while intrasellar residual tumors were found in the remaining 10 patients. No severe complications occurred. Out of the 10 patients with residual tumors, 8 underwent postoperative X-knife therapy, without visual defects or pituitary function failure. Follow-up observations in these 8 patients for 5～26 months (mean,14.8 months) revealed no recurrence. Conclusions Transorbital subfrontal approach surgery which is characterized by simplicity of its performance facilitates the radical resection of tumors and the avoidance of complications. Postoperative X-knife therapy may further control the recurrence of tumors.

Craniofacial Resection with Subfrontal Approach / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The classic craniofacial resection for anterior skull base tumor uses bifrontal craniotomies together with lateral rhinotomies. This approach requires frontal lobe retraction and may be associated with the development of brain edema and encephalomalacia. The subfrontal approach by use of supraorbital-frontal bone osteotomy permits removal of anterior skull base lesions with minimal retraction of frontal lobe and provides excellent exposure by reducing the depth and obliquity of the approaches and lowering the inferior visual angle. MATERIALS AND METHODS: We reviewed 3 cases of anterior skull base tumor involving the frontal, sphenoid sinus and partially clivus, or frontal lobe. They were 1 female patient and 2 male patients aging from 56 to 64. RESULTS: We obtained sound results, both functionally and cosmetically, except for one who died of brain metastasis. CONCLUSION: The craniofacial resection with subfrontal approach using supraorbital-frontal bone osteotomy provides excellent exposure, particularly in high grade malignancy of the anterior skull base, and can reduce postoperative morbidities.

Microsurgical Treatment of Suprasellar Meningiomas

Suprasellar meningiomas are uncommon intracranial tumors representing approximately 4-10% of intracranial meningiomas and the total excision is sometimes hazardous because of surrounding vital structures. We have experienced four cases of this lesion during last three years and the masses were approached through frontoparietal craniotomy and lateral subfrontal approach and were removed completely with microsurgical technique. Visual disturbances were improved in three cases and unchanged in one case. The literatures are also reviewed.

Calcified Pituitary Adenomas

Two cases of calcified pituitary adenoma are reported, which comprise 2.44% among a surgical series of 82 pituitary adenomas. Both patients had very high serum prolactin level, which suggested the possibility of hormonal influence in formation of the calcification. The tumors were removed by a subfrontal approach to prevent and reduce possible damage to the surrounding structures.