Unilateral versus Bilateral Subfrontal Craniotomy in Management of Olfactory Groove Meningiomas

Introduction: Olfactory groove meningiomas (OGMs) arise from the midline at the ethmoid cribriform plate and comprise 8 to 13% of anterior cranial fossa meningiomas. Due to the relative ineloquence of the location, these tumors are frequently able to grow to a large size prior to clinical presentation. This presents a unique surgical challenge. These tumors can be resected via a transcranial or an endoscopic endonasal transethmoid approach. Larger tumors extending beyond the plane of the optic nerve typically require a transcranial approach. The approach is subfrontal, and can be either unilateral or bilateral, with the latter providing a more robust exposure and direct access to the site of origin. On the other hand, the unilateral approach may have a lower rate of complications and only places one frontal lobe at risk of retraction injury. In this study, we compare our outcomes between unilateral and bilateral subfrontal craniotomies for resection of OGMs.