fig7

Figure 7. A 68-year-old female presented with progressive periorbital headaches with preserved olfaction. (Top Row) Pre-operative imaging demonstrates an olfactory groove meningioma extending posteriorly to the anterior portion of the planum sphenoidale. The lateral extent of the tumor is confined within the medial aspects of the orbits bilaterally. This tumor is therefore amenable to an endoscopic endonasal transcribriform approach, however, to preserve olfaction we elected to approach this tumor through a left supraorbital eyebrow craniotomy. (Bottom Row) Post-operative imaging demonstrates gross total removal of the meningioma. Top right image shows a post-operative CT scan demonstrating the size of the supraorbital craniotomy. The endoscopic was used to ensure removal of tumor within the depths of the olfactory groove. Axial FLAIR imaging demonstrates no retraction injury to the left frontal lobe. Olfaction was preserved. An endoscopic endonasal trasnscribrifom approach would have guaranteed loss of olfaction and therefore is not the optimal approach.