Exoscopic resection of an Olfactory Groove Meningioma through an Anterior Interhemispheric Approach

Olfactory groove meningiomas are challenging lesions due to their proximity to major vascular structures and frequent frontal lobe edema or hyperostosis. Various transcranial and endoscopic approaches have been described, each with specific advantages and limitations. We present the case of a 70-year-old woman with longstanding anosmia who recently developed apathy and irritability. An olfactory groove meningioma was resected through an anterior interhemispheric approach, chosen to minimize subfrontal parenchymal traction (Video 1). Exoscopic visualization provided excellent illumination and magnification throughout the procedure. The surgery was completed with a gross-total resection, showing the feasibility and safety of this approach for selected cases.