CASE REPORT

Preoperative Embolization in Management of Giant Olfactory Groove Meningioma

Embolização Pré-Operatória no Manejo de Meningiomas Gigantes da Goteira Olfatória

  • Breno Nery    Breno Nery
  • Eduardo Quaggio    Eduardo Quaggio
  • José Alencar de Sousa Segundo    José Alencar de Sousa Segundo
  • Mateus Wendler Ferreira Lopes    Mateus Wendler Ferreira Lopes
  • Francisco Thiago de Moura Sousa    Francisco Thiago de Moura Sousa
  • Marina Rodrigues Ramalho    Marina Rodrigues Ramalho
  • Emilly Rayssa Passos de Lima    Emilly Rayssa Passos de Lima
  Views: 16
  Downloads: 1

Resumo

Os meningiomas gigantes da goteira olfatória geralmente se originam da lâmina crivosa do osso etmoide e representam um desafio significativo na prática neurocirúrgica. Esses tumores frequentemente apresentam envolvimento bilateral e podem comprimir os lobos frontais e os nervos cranianos. No que diz respeito ao tratamento, a embolização pré-operatória das artérias etmoidais por meio da artéria oftálmica pode representar uma estratégia importante para reduzir a perda sanguínea intraoperatória e o tempo cirúrgico, particularmente em pacientes com alto risco cardiovascular. Este estudo compara os desfechos da embolização pré-operatória no manejo de dois pacientes com OGMs gigantes e sugere que esse procedimento deve ser considerado em pacientes que não toleram perdas sanguíneas significativas.

Palavras-chave

Meningioma; Neoplasias da base do crânio; Período pré-operatório; Embolização terapêutica

Abstract

Giant olfactory groove meningiomas (OGMs) usually originate from the cribriform plate of the ethmoidal bone and represent a significant challenge in neurosurgical practice. These tumors often exhibit bilateral involvement and may compress the frontal lobes and cranial nerves. Regarding treatment, preoperative embolization of the ethmoidal arteries via the ophthalmic artery may be an important strategy to reduce intraoperative blood loss and surgical time, particularly in patients at high cardiovascular risk. This study compares the outcomes of preoperative embolization in the management of two patients with giant OGMs and suggests that this procedure should be considered for patients who cannot tolerate significant blood loss.

Keywords

Meningioma; Skull base neoplasms; Preoperative period; Therapeutic embolization

References

 1. Ogasawara C, Philbrick BD, Adamson DC. Meningioma: a review of epidemiology, pathology, diagnosis, treatment, and future directions. Biomedicines. 2021;9(3):319. https://doi.org/10.3390/ biomedicines9030319. PMid:33801089.

2. Tuna H, Bozkurt M, Ayten M, Erdogan A, Deda H. Olfactory groove meningiomas. J Clin Neurosci. 2005;12(6):664-8. https://doi. org/10.1016/j.jocn.2005.05.002. PMid:16109489.

3. Cembraneli PN, Cavalcante JBF, Cembraneli IN, et al. Surgical technique for olfactory groove meningioma: case series and literature revision. J Bras Neurocir. 2025;36(2):206-12. https://doi.org/10.22290/ jbnc.2025.360212.

4. Pepper JP, Hecht SL, Gebarski SS, Lin EM, Sullivan SE, Marentette LJ. Olfactory groove meningioma: discussion of clinical presentation and surgical outcomes following excision via the subcranial approach. Laryngoscope. 2011;121(11):2282-9. https://doi.org/10.1002/lary.22174. PMid:21994142.

5. Ciurea AV, Iencean SM, Rizea RE, Brehar FM. Olfactory groove meningiomas. Neurosurg Rev. 2012;35(2):195-202. https://doi. org/10.1007/s10143-011-0353-2. PMid:21960302.

6. Felbaum DR, Mueller K, Liu AH, Armonda RA. Onyx embolization of a meningioma with a dysplastic aneurysmal anterior cerebral artery vessel. Cureus. 2016;8(9):e776. https://doi.org/10.7759/cureus.776. PMid:27738575.

7. Villalonga JF, Cervio A, Mormandi R, Alcorta SC, Sevlever G, Salvat J. Surgical treatment of cerebellar hemangioblastomas. Surg Neurol Int. 2017;8(1):163. https://doi.org/10.4103/sni.sni_490_16. PMid:28840067.

8. Ilyas A, Przybylowski C, Chen CJ, et al. Preoperative embolization of skull base meningiomas: a systematic review. J Clin Neurosci. 2019;59: 259-64. https://doi.org/10.1016/j.jocn.2018.06.022. PMid:30279120.

9. Calvanese F, Auricchio AM, Lehecka M. Exoscopic resection of giant olfactory groove meningioma. Neurosurg Focus Video. 2024;10(1):V6. https://doi.org/10.3171/2023.10.FOCVID23125. PMid:38283807.

10. Lallani SB, Adams D, Doan H, Trieu E, Doan N. Child abuse: the consequence of an undiagnosed giant olfactory groove meningioma? Cureus. 2021;13(2):e13582. https://doi.org/10.7759/cureus.13582. PMid:33796425.

11. Essibayi MA, Rao JR, Patel IP, et al. Transophthalmic artery embolization of anterior skull base meningiomas: case series and technical considerations. AJNR Am J Neuroradiol. 2024;ajnr.A8624. https://doi.org/10.3174/ajnr.A8624.

12. Wei CP, Wang AD, Tsai MD. Resection of giant olfactory groove meningioma with extradural devascularization. Skull Base. 2002;12(1): 27-31. https://doi.org/10.1055/s-2002-21570-1. PMid:17167639.

13. Przybylowski CJ, Baranoski JF, See AP, et al. Preoperative embolization of skull base meningiomas: outcomes in the Onyx era. World Neurosurg. 

2018;116:e371-9. https://doi.org/10.1016/j.wneu.2018.04.208. PMid:29751190.

14. Akimoto T, Ohtake M, Miyake S, et al. Preoperative tumor embolization prolongs time to recurrence of meningiomas: a retrospective propensity-matched analysis. J Neurointerv Surg. 2023;15(8):814-20. https://doi.org/10.1136/neurintsurg-2022-019080. PMid:35803729.

15. Raper DM, Starke RM, Henderson F Jr, et al. Preoperative embolization of intracranial meningiomas: efficacy, technical considerations, and complications. AJNR Am J Neuroradiol. 2014;35(9):1798-804. https://doi.org/10.3174/ajnr.A3919. PMid:24722303.

16. Jumah F, AbuRmilah A, Raju B, et al. Does preoperative embolization improve outcomes of meningioma resection? A systematic review and meta-analysis. Neurosurg Rev. 2021;44(6):3151-63. https://doi. org/10.1007/s10143-021-01519-z. PMid:33723970.

17. Chen L, Li DH, Lu YH, Hao B, Cao YQ. Preoperative embolization versus direct surgery of meningiomas: A meta-analysis. World Neurosurg. 2019;128:62-8. https://doi.org/10.1016/j.wneu.2019.02.223. PMid:30954743.

18. Eskey CJ, Meyers PM, Nguyen TN, et al. indications for the performance of intracranial endovascular neurointerventional procedures: a scientific statement from the American Heart Association. Circulation. 2018;137(21):e661-89. https://doi.org/10.1161/ CIR.0000000000000567. PMid:29674324.

19. Aydin MV, Yangi K, Toptas E, Aydin S. Skull Base collision tumors: giant non-functioning pituitary adenoma and olfactory groove meningioma. Cureus. 2023;15(9):e44710. https://doi.org/10.7759/ cureus.44710. PMid:37809125.



1Neurosurgery Department, Hospital Beneficência Portuguesa de Ribeirão Preto, Ribeirão Preto, SP, Brazil.

2Centro Universitário UNIFACISA, Campina Grande, PB, Brazil.


 

Received Jan 22, 2026 

Corrected Apr 23, 2026 

Accepted May 7, 2026

JBNC  Brazilian Journal of Neurosurgery

JBNC
  •   ISSN (print version): 0103-5118
  •   e-ISSN (online version): 2446-6786
iThenticate
Open Access

Contact

Social Media

   

ABNc  Academia Brasileira de Neurocirurgia

  •   Rua da Quitanda 159 – 10º andar - Centro - CEP 20091-005 - Rio de Janeiro - RJ
  •   +55 21 2233.0323
  •    abnc@abnc.org.br

Sponsor

  • Hospital INC