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The first 25 slides, exactly as they appear. The full deck has 53 content slides.
Neurosurgery
Surgical Management of Olfactory Groove Meningiomas
Built from Feldman — Neurosurgical Operative Atlas: Neuro-Oncology
What’s inside
7 sections · 53 slides
Overview
- What this deck will teach you
The Tumor and Its Territory
What an olfactory groove meningioma is, and why its location shapes everything
- Start here: what is a meningioma?
- Where the olfactory groove is
- Olfactory groove meningioma (OGM) defined
- OGM by the numbers
Presentation and Patient Selection
Why these tumors hide, and how we decide to operate
- Why the symptoms sneak up
- Late symptoms and what they signal
- Who to operate on versus who to watch
- The essential pre-surgery workup
Imaging and Surgical Planning
Reading the scans to map blood supply, vision, and the safest corridor
- CT and MRI answer different questions
- What T2 imaging and angiography add
- MRI of a large olfactory groove meningioma
- Where these tumors get their blood
- The menu of surgical approaches
- Non-negotiable maneuvers, whatever the approach
- Matching the approach to the tumor
- The goals every operation aims for
The Bifrontal Biorbital Approach
The open route for large tumors
- Positioning and the scalp incision
- Turning the flap while sparing the facial nerve
- Freeing the pericranium and the brow bundles
- Bifrontal craniotomy with biorbital osteotomies
- Cutting the bone: craniotomy and orbital osteotomies
- Devascularizing the tumor early
- Removing the tumor safely
- Protecting smell, nerves, and arteries
- Finishing: bone, dura, and a watertight floor
The Endoscopic Endonasal Approach
Reaching the same tumor from below, through the nose
- What the nasal route reaches, and its five steps
- Anesthesia, drains, and positioning
- Raising the nasoseptal flap
- Optic nerves and ethmoidal artery anatomy
- Clearing the corridor to the cribriform plate
- Devascularizing and taking down the cribriform plate
- Endonasal resection of a skull base meningioma
- A key nuance: finding the arteries safely
- Rebuilding the floor: the gasket-seal closure
- Gasket-seal skull base reconstruction, step by step
- Backup flaps and finishing the nose
Recovery, Outcomes, and Recurrence
What happens after surgery and what to expect long term
- Postoperative care
- CSF drainage differs by approach
- Reported complication rates, past 10 years
- Outcomes are generally excellent
- Recurrence and how to prevent it
- Three keys to low recurrence
- The takeaways
- Why is early interruption of the blood supply central to removing an OGM, and where does that supply come from?
- Neurosurgical Operative Atlas: Neuro-Oncology