gms | German Medical Science

67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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Intracranial meningiomas affecting the olfactory sensory system: pre- and postoperative olfactory perfomance status

Meeting Abstract

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  • Philipp Hendrix - Department of Neurosurgery, Saarland University Hospital, Homburg/Saar, Germany
  • Julian Krug - Department of Neurosurgery, Saarland University Hospital, Homburg/Saar, Germany
  • Alan Linnebach - Department of Neurosurgery, Saarland University Hospital, Homburg/Saar, Germany
  • Stefan Linsler - Department of Neurosurgery, Saarland University Hospital, Homburg/Saar, Germany
  • Joachim Oertel - Department of Neurosurgery, Saarland University Hospital, Homburg/Saar, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMO.04.06

doi: 10.3205/16dgnc020, urn:nbn:de:0183-16dgnc0209

Published: June 8, 2016

© 2016 Hendrix et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Meningiomas are mostly slow-growing, benign tumors. This may cause progressive compression of the olfactory sensory system. Occasionally, meningiomas infiltrate olfactory nerve structures. Surgical resection is the most common recommended treatment. Compression of the olfactory system, infiltration of olfactory nerve structures and especially surgical approaches to the anterior cranial fossa may alter olfactory performance. Hence, we studied the olfactory status of patients undergoing meningioma resection.

Method: From January till June 2015, patients surgically treated for meningiomas that affect the olfactory system underwent prospective assessment of olfactory performance. Monostril and binostril olfactory function was tested via a validated sniffin‘ sticks test battery that allows classification into either normosmic, hyposmic or anosmic status.

Results: Preoperatively, a total of 21 patients were tested. Compression of the basal frontal lobe due to meningioma mass effect or perifocal edema was seen in 19 patients. A total of 9 patients presented with olfactory nerve infiltration, 2 out of these 9 patients did not show compression of the basal frontal lobe. Before surgery, 4 out of 21 patients (19%) showed bilateral anosmia (1 bilateral olfactory groove meningioma with nerve infiltration, and 1 falcine, 1 convexity and 1 sphenoid meningioma with a tumorvolume of 31 - 38 cm3 causing severe basal frontal lobe compression in all 3 cases). Two other patients (9.5 %), each suffering from olfactory groove meningioma, displayed unilateral anosmia. Six out of the 9 patients (66.7 %) with infiltrated olfactory nerve structures did not display severe olfactory dysfunction. Postoperatively, 14 out of 21 (66.7 %) patients underwent follow-up olfactory testing (mean 50 days). Two patients (14.3 %) with frontal convexity meningiomas with extensive perifocal edema experienced olfactory deterioration to anosmia. However, 4 patients (28.6 %) regained olfactory function (2 olfactory groove meningiomas, 2 falcine meningiomas) after surgical resection.

Conclusions: Meningiomas causing compression of the olfactory sensory system or infiltrating olfactory nerve structures may cause preoperative olfactory dysfunction. Surgical resection may alter olfactory performance and importantly may lead to restoration of olfactory function.