Olfactory groove meningioma. The mucosa of the frontal sinus has been removed, and the sinus is packed with bacitracin-soaked getfoam and covered with a flap of peiicranial tissue sewn to the dura. The anterior sagittal sinus is ligated. The blood supply coming in through the midline base of the skull is being occluded and an internal decompression of the tumor done. The capsule of the tumor is being reflected into the area of internal tumor decompression and the attachments to the surrounding brain divided.
Minimal retraction is placed on the surrounding brain.
The dural attachment has been excised. The bone usually does not need to be removed. The area is covered with a graft of perieranial tissue and gelfoam. This approach is associated with the smallest amount of retraction on the frontal lobes, gives direct access to all sides of the tumor, and allows one to decompress the tumor while working along the base of the skull to interrupt the blood supply. Guthrie et al.