2026 Poster Presentations
P146: EYEBROW CRANIOTOMY VERSUS TRADITIONAL OPEN APPROACH FOR OLFACTORY GROOVE MENINGIOMA
Asad Lak, MD; Pujit Mekala, BS; Jeremy Greenlee, MD; University of Iowa
Background: Olfactory groove meningioma has largely been addressed through wide surgical exposure techniques including bicoronal or pterional craniotomy. Outcomes comparing traditional approaches to minimally invasive approach like the eyebrow craniotomy are lacking.
Methods: Institutional records at the authors’ institution were reviewed over the last 10 years to include surgically resected olfactory groove meningioma. Variables of interest included demographics, grade of meningioma, tumor volume & height, size of frontal sinus, distance of tumor from posterior table of sinus, surgical approach, extent of resection, recurrence, complications and follow up. Statistical analysis was performed using independent t-test for continuous and Chi-square test for categorical variables.
Results: A total of 51 patients were identified. Average age was 55 years and 70.5% (n=36) were female. Grade I tumor was found in 57% (n=29) and gross total resection (GTR) was achieved in 84% (n=43). The risk of recurrence was 12% (n=06). The mean tumor volume was 51 cm3 and height was 3.5 cm. The mean frontal sinus measured 4 cm. Eyebrow craniotomy was performed in 15 patients and traditional open approach was performed in 34 cases. 2 patients underwent endoscopic endonasal approach and were excluded for subgroup comparison. The incidence of complications was 25% (n=13) with CSF leak and seizures being the most common. The average length of hospital stay was 7 days and mean follow up was 33 months.
Within the eyebrow subgroup, mean age was 54 years and 73% (n=11) were female. Grade I meningioma was present in 60% (n=09) and GTR was achieved in 93% cases (n=14). The mean tumor volume was 17 cm3 and mean height was 2.5 cm. The average size of frontal sinus was 4 cm and average distance of tumor from frontal sinus was 1.5 cm. The risk of recurrence was 13% (n=02) and the risk of complications was 20% (n=03). The average length of hospital stay was 4 days and mean follow up was 40 months.
Within the traditional open subgroup, mean age was 56 years and 73.5% (n=25) were female. Grade I meningioma was present in 53% (n=18) patients and GTR was achieved in 80% (n=27). The mean tumor volume was 68 cm3 and mean height was 4 cm. The average size of frontal sinus was 4.5 cm and average distance of tumor from frontal sinus was 0.8 cm. The risk of recurrence was 9% (n=03) and the risk of complications was 25% (n=09). The average length of hospital stay was 8 days and mean follow up was 29 months.
Statistical analysis revealed tumors in the eyebrow subgroup had significantly smaller volume (p<0.001), shorter height (p<0.001) and were farther from the frontal sinus as compared to traditional approach (p=0.003). The length of stay was significantly shorter in eyebrow subgroup (p=0.02).
Conclusion: Eyebrow craniotomy offers a shorter length of stay and improved cosmesis as compared to traditional approach for smaller olfactory groove meningiomas with a comparable clinical outcomes. The size of frontal sinus does not appear to be a limiting factor in selecting eyebrow approach.
