Olfactory Groove Meningioma Extension to Paranasal Sinus and Nasal Cavity: Combined Approach by Unilateral Subfrontal and Endoscopic Endonasal

The local extension of olfactory groove meningioma into the paranasal sinuses and nasal cavity eroding underlying bone in young patients is considered as an unusual and extremely rare event. We report the case of a 25-year-old female of primary growth of olfactory groove meningioma extension to left ethmoidal sinus and nasal cavity, presented with sudden onset of seizure after delivering a baby. Although olfactory groove meningioma can grow to extreme size with unnoticed symptoms, frequent nasal obstruction, unilateral headache and gradual loss of smell are described. Head image revealed large mass into the anterior cranial fossa extending into the paranasal sinus and left nasal cavity containing cancellous bone. Considering the possibility of postoperative morbidity and mortality, complete removal of large tumor and the dura tail that extends beyond its attachment at skull base becomes challenging. The combined unilateral subfrontal and endoscopic endonasal approach is applied to achieve the Simpson grade-I removal.