Gazzeri Roberto, Galarza Marcelo, Gazzeri Giovanni
Department of Neurosurgery, San Giovanni Addolorata Hospital, Via O. Tommasini 13, 00162, Rome, Italy.
Acta Neurochir (Wien). 2008 Nov;150(11):1117-25; discussion 1126. doi: 10.1007/s00701-008-0142-z. Epub 2008 Oct 21.
Olfactory groove meningiomas arise in the midline along the dura of the cribriform plate and may reach a large size before producing symptoms. We conducted a retrospective study of patients with these lesions focused on pre- and post-operative investigations for ophthalmological, personality and cognitive disturbances.
The authors reviewed 36 patients with giant olfactory groove meningiomas surgically treated via a bifrontal approach. Ophthalmological evaluation included visual acuity, fundoscopy and visual fields while psychological evaluation included a Mini-Mental State Examination. Data was collected before, 1 and 12 months after surgery. Formal pre- and post-operative ophthalmological examinations discovered visual deficits in 55.5% of the patients. Within the first month after surgery, improvement of visual acuity and of visual field deficits was observed. In post-operative neuropsychological testing, higher mental functions showed improvement. The most frequent post-operative complication was persistent rhinorrhoea in two patients.
Results at longest follow up indicate that cognitive changes and visual deficits will improve in patients with giant olfactory groove meningiomas after a bifrontal approach, without additional neurological deficits.
嗅沟脑膜瘤起源于沿筛板硬脑膜的中线部位,在出现症状之前可能长得很大。我们对患有这些病变的患者进行了一项回顾性研究,重点关注术前和术后对眼科、人格及认知障碍的检查。
作者回顾了36例经双额入路手术治疗的巨大嗅沟脑膜瘤患者。眼科评估包括视力、眼底检查和视野检查,而心理评估包括简易精神状态检查。在手术前、术后1个月和12个月收集数据。术前和术后的正式眼科检查发现55.5%的患者存在视力缺陷。在术后第一个月内,观察到视力和视野缺陷有所改善。在术后神经心理学测试中,高级心理功能有所改善。最常见的术后并发症是两名患者出现持续性鼻漏。
最长随访结果表明,采用双额入路治疗巨大嗅沟脑膜瘤的患者,认知变化和视力缺陷将得到改善,且无额外的神经功能缺损。