• Libório Dos Santos Adriana Rodrigues AR Neurosurgery Department, Ipanema Federal Hospital, Rio de Janeiro, Brazil. Electronic address: adriana_liborio@hotmail.com., Calfat Maldaun Marcos Vinícius MV Neurosurgery Department, Sírio Libanês Hospital, São Paulo, Brazil., Gripp Daniel Andrade DA Neurosurgery Department, Sírio Libanês Hospital, São Paulo, Brazil., Jonathan Watanabe, Fujiki Ricardo Hiroshi RH BA Pontifical University Catholic of São Paulo, São Paulo, Brazil., and Pires de Aguiar Paulo Henrique PH Neurosurgery Department, Sírio Libanês Hospital, São Paulo, Brazil; State Public Servant Hospital (IAMSPE), São Paulo, Brazil..
• Neurosurgery Department, Ipanema Federal Hospital, Rio de Janeiro, Brazil. Electronic address: adriana_liborio@hotmail.com.
• World Neurosurg. 2018 Dec 1; 120: 316-319.

BackgroundSkull base tumors, such as large olfactory groove meningiomas (OGMs), are a challenge for neurosurgeons. However, the tendency to reduce invasive surgeries is gaining more adepts. We describe a minimally invasive interhemispheric approach with a falx window for microsurgical resection of the giant OGM as a technical note.MethodsA minimal medial frontal craniotomy measuring 3-5 cm in size is performed, and an interhemispheric approach is combined with an opening in the falx to improve microsurgical resection of the giant OGM. The technique and more details are described.ResultsA minimally invasive interhemispheric approach with a falx window was performed in this case. Gross total resection of the OGM was possible with minimal brain retraction. Simpson grade I was achieved, and there was a good outcome on the postoperative recovery period of the patient, with vision improvement, preservation of olfaction, and no other complications.ConclusionsThe minimally invasive interhemispheric approach with a falx window is effective and safe for giant OGM with a good outcome for the patient. The opening in the falx improves the interhemispheric pathway and allows gross total resection with minimal brain retraction and low morbidity.Copyright © 2018 Elsevier Inc. All rights reserved.

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