A 45-year-old individual who experienced progressive loss of vision in both eyes over a span of two months was stunned to learn that a massive 8-centimeter skull base tumor was the underlying cause. Fortunately, neurosurgeons at People’s Hospital 115 in Ho Chi Minh City successfully resected the giant growth using an ultra-minimally invasive keyhole approach through the eyebrow.
Gradual Vision Loss and an Overlooked Warning Sign
Upon admission, the patient reported experiencing worsening bilateral blurred vision for roughly eight weeks. Aside from a mild, intermittent headache, there was no limb weakness or obvious motor impairment. However, a detailed medical history revealed a subtle, unnoticed loss of smell (anosmia) that had developed long before visual disturbances began.
A cranial Magnetic Resonance Imaging (MRI) scan revealed an enormous 8-centimeter olfactory groove meningioma located at the anterior skull base. The massive lesion exerted severe compressive pressure on both frontal lobes and directly compromised the optic chiasm and optic nerves, putting the patient at immediate risk of irreversible blindness.
Minimally Invasive Supraorbital Eyebrow Craniotomy
Faced with an exceptionally large lesion in an intricate anatomical corridor, the surgical team led by Dr. To Thanh Toan from the Department of Neurosurgery elected to perform a minimally invasive supraorbital keyhole craniotomy.
Instead of traditional, extensive open-skull procedures, the surgeons made a small incision carefully concealed within the natural crease of the eyebrow. Utilizing high-definition neuro-endoscopy and advanced microsurgical instrumentation, the team successfully dissected and removed the entire 8cm tumor while preserving all surrounding critical neural structures and cerebral blood vessels.
Post-operative cranial CT scan showing the complete resection of the massive tumor. Photo: People’s Hospital 115
Rapid Recovery and Superior Cosmetic Outcomes
Following the operation, the patient was monitored in intensive care for 24 hours. Follow-up computed tomography (CT) scans confirmed total tumor eradication. The patient demonstrated significant visual improvement, clear mental status, and zero new neurological deficits.
Because the incision was hidden within the eyebrow line, the surgical scar became virtually undetectable upon healing. The patient recovered smoothly and was safely discharged just five days post-surgery, showcasing the outstanding aesthetic and therapeutic benefits of contemporary skull base microsurgery.
Recognizing the Silent Signs of Olfactory Groove Meningiomas
According to Dr. To Thanh Toan, olfactory groove meningiomas develop very slowly in the anterior cranial fossa. During early stages, symptoms are notoriously subtle—often limited to gradual loss of smell, vague headaches, or mild visual blurriness—which patients frequently dismiss.
By the time such tumors reach a massive size, individuals face grave risks, including permanent visual impairment, cognitive deterioration, and major behavioral changes. Medical professionals urge anyone experiencing unexplained, prolonged visual disturbances, chronic headaches, or impaired smell to seek prompt neuroimaging and specialized clinical evaluation.
