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Neurological Surgery No Shinkei Geka Volume 21, Issue 3 （March 1993）

Neurological Surgery 脳神経外科 21巻3号（1993年3月発行）

Japanese English

症例

巨大なOlfactory Groove Meningiomaに対するExtensive Transfrontal Approach Surgical Excision of a Huge Olfactory Groove Meningioma by Extensive Transfrontal Approach 中瀬裕之 ¹ , 大西英之 ¹ , 東保肇 ¹ , 宮本享 ¹ , 森迫敏貴 ¹ , 渡部安晴 ¹ , 伊東民雄 ¹ , 山田圭介 ¹ , 芝元啓治 ¹ , 唐澤淳 ¹ Hiroyuki NAKASE ¹ , Hideyuki OHNISHI ¹ , Hajime TOUHO ¹ , Susumu MIYAMOTO ¹ , Toshitaka MORISAKO ¹ , Yasuharu WATABE ¹ , Tamio ITOH ¹ , Keisuke YAMADA ¹ , Keiji SHIBAMOTO ¹ , Jun KARASAWA ¹ ¹大阪脳神経外科病院脳神経外科 ¹Department of Neurosurgery, Osaka Neurological Institute キーワード： Olfactory groove meningioma , Skull base surgery , Extensive transfrontal approach Keyword: Olfactory groove meningioma , Skull base surgery , Extensive transfrontal approach pp.263-267

発行日 1993年3月10日 Published Date 1993/3/10

DOI https://doi.org/10.11477/mf.1436900619

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Abstract 文献概要
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I．はじめに

　近年，頭蓋底外科の発展に伴い，充分な視野が確保されかつ脳の圧排を最小限におさえる手術法が工夫されている．

　olfactory groove meningioma（以下OGM）は，全髄膜腫の約3.8％を占め^5），嗅覚低下が唯一の症状であるため患者が異常に気づくのが遅れ，かなり大きくなってから発見されることが多く，前頭葉の部分切除が行われることもある^4,10）．今回われわれは，巨大なOGMに対し，Extensive transfrontal approachを行い良好な結果が得られたので，手術術式を中心に報告する．

A case with a huge olfactory groove meningioma was cured surgically by extensive transfrontal approach.

A 46-year-old female was admitted with complains of left visual disturbance. CT revealed a large high-density mass in the base of the frontal fossa which was en-hanced homogenously. Hyperostosis was seen in the planum sphenoidale. MRI showed a relatively low in-tensity with a peritumoral low-intensity rim on T1WI and high intensity on T2WI. The brain stem had shifted dorsally. Rich feeding to the lesion from the ethomoidal artery was seen on angiography. An operation was performed using an extensive transfrontal approach. After bifrontal craniotomy, orbi-tofrontal osteotomy was performed. This approach en-abled us to minimize frontal lobe retraction, to interrupt the blood supply to the tumor early, and to remove the tumor completely from the frontal base and to present invasion of the sinuses. The postoperative course was uneventful without cosmetic problems.