An endoscopic endonsal transethmoidal approach to olfactory groove meningioma.

Kim Y et al. An Endoscopic Endonsal Transethmoidal ... Cen Eur Neurosurg 2011; 72: 205–208 Introduction ▼ Olfactory groove meningiomas (OGMs) are traditionally accessed through a subfrontal, pterional, or interhemispheric approach. Although the removal of the bony structures of the skull base provides direct access to these tumors, these approaches still require some manipulation due to their lateral-to-medial trajectory [ 5 , 16 ] . In contrast, the endonasal transethmoidal approach for a centrally located anterior skull base lesion has the advantage of direct access to the lesion and possible feeding vessels without the need for retraction of the brain or neurovascular structures. In addition, recent advances in the understanding of skull base anatomy, accuracy of neuronavigation, and optical endoscopy technology promote the endoscopic endonasal approach for centrally located skull base lesions [ 6 ] . Based on this background, we report 2 OGM cases treated by a purely endoscopic endonasal transethmoidal approach and present the pros and cons of endoscopic endonasal surgical approaches for anterior skull base lesions.