The Role of the Expanded Endoscopic Endonasal Approach in Staged Surgery for Giant Olfactory Groove Meningioma: Technical Nuances

Background Giant olfactory groove meningiomas (OGMs) are unique tumors that present a formidable challenge to skull base surgeons. They are highly vascular lesions, deriving their main blood supply from the anterior and posterior ethmoidal arteries. Each skull base approach and technique have advantages and limitations that must be considered when selecting the optimum treatment plan for each patient. Craniotomies are limited when dealing with severe brain edema, reaching the tumor blood supply, hyperostosis of the skull base, and sinonasal invasion. Endoscopic endonasal approaches (EEAs) are limited reaching lateral meningioma implantation. Therefore, planning the surgical strategy to attack these tumors while achieving the optimum outcome with minimal complications is demanding.