Microsurgical resection of olfactory groove meningioma via the pterional transsylvian approach with preservation of the bilateral olfactory nerves

Olfactory groove meningiomas are slow-growing tumors arising from the dura of the cribriform plate and adjacent to the crista galli in the anterior cranial fossa. These tumors are frequently diagnosed late and may reach a very large size. Several surgical approaches have been described for olfactory groove meningiomas. The pterional transsylvian approach facilitates preservation of the olfactory nerves in most cases, allows for gross-total resection, and provides early access to vital structures. This video presents the successful treatment of a patient with an olfactory groove meningioma, with preservation of the bilateral olfactory nerves via the pterional transsylvian approach. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25181.