Colin J Przybylowski1, Shawn L Hervey-Jumper2, Nader Sanai3. 1. Department of Neurosurgery, Ivy Brain Tumor Research Center, Barrow Neurological Institute, Phoenix, AZ, USA. 2. Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA. 3. Department of Neurosurgery, Ivy Brain Tumor Research Center, Barrow Neurological Institute, Phoenix, AZ, USA. nader.sanai@barrowbrainandspine.com.
Abstract
PURPOSE: The goal of this article is to review the outcomes of insular glioma surgery and discuss strategies to minimize postoperative morbidity. METHODS: The authors reviewed the published literature on low- and high-grade insular gliomas with a focus on glioma biology, insular anatomy, and surgical technique. RESULTS: Maximal safe resection of insular gliomas is associated with improved survival and is the primary goal of surgery. Protecting patient speech and motor function during insular glioma resection requires versatile integration of insular anatomy, cortical mapping, and microsurgical technique. Both the transsylvian and transcortical corridors to the insula are associated with low morbidity profiles, but the transcortical approach with intraoperative mapping is more favorable for gliomas within the posterior insular region. CONCLUSIONS: Surgical strategy for insular gliomas is dependent on biological, anatomical, and clinical factors. Technical mastery integrated with intraoperative technologies can optimize surgical results.
PURPOSE: The goal of this article is to review the outcomes of insular glioma surgery and discuss strategies to minimize postoperative morbidity. METHODS: The authors reviewed the published literature on low- and high-grade insular gliomas with a focus on glioma biology, insular anatomy, and surgical technique. RESULTS: Maximal safe resection of insular gliomas is associated with improved survival and is the primary goal of surgery. Protecting patient speech and motor function during insular glioma resection requires versatile integration of insular anatomy, cortical mapping, and microsurgical technique. Both the transsylvian and transcortical corridors to the insula are associated with low morbidity profiles, but the transcortical approach with intraoperative mapping is more favorable for gliomas within the posterior insular region. CONCLUSIONS: Surgical strategy for insular gliomas is dependent on biological, anatomical, and clinical factors. Technical mastery integrated with intraoperative technologies can optimize surgical results.
Authors: Ramin A Morshed; Jacob S Young; Seunggu J Han; Shawn L Hervey-Jumper; Mitchel S Berger Journal: J Neurosurg Date: 2018-09-21 Impact factor: 5.115
Authors: Laura A Snyder; Andrew B Wolf; Mark E Oppenlander; Robert Bina; Jeffrey R Wilson; Lynn Ashby; David Brachman; Stephen W Coons; Robert F Spetzler; Nader Sanai Journal: J Neurosurg Date: 2013-12-06 Impact factor: 5.115