Nicholas B Dadario1, Ashraf Zaman2,3,4, Madhavi Pandya3, Brian J Dlouhy2,5, Manuri P Gunawardena2, Michael E Sughrue2, Charles Teo6. 1. Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA. 2. Centre for Minimally Invasive Neurosurgery, Prince of Wales Hospital, Suite 19, Level 7 Prince of Wales Private Hospital, Barker Street, Randwick, Sydney, NSW, 2031, Australia. 3. Garvan Institute of Medical Research, Sydney, Australia. 4. Faculty of Medicine, University of New South Wales, Sydney, Australia. 5. Department of Neurosurgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa, 52242, USA. 6. Centre for Minimally Invasive Neurosurgery, Prince of Wales Hospital, Suite 19, Level 7 Prince of Wales Private Hospital, Barker Street, Randwick, Sydney, NSW, 2031, Australia. charlie@neuroendoscopy.info.
Abstract
PURPOSE: Gliomas that spread along the white matter tracts of the corpus callosum to both hemispheres have traditionally been considered surgically challenging largely due to the relative complexity of safely achieving complete resections. We present a series of endoscopic-assisted resections of butterfly gliomas with post-operative radiological assessment of EOR and clinical outcome data. METHODS: Retrospective review of patients who underwent surgical resection of a butterfly glioma from 2007 to 2020. Butterfly gliomas were defined as gliomas, which appeared to arise from the corpus callosum with significant bilateral extension. All records were retrospectively reviewed with operative/clinical outcomes and complications recorded. RESULTS: 70 patients who underwent an endoscopic-assisted transcortical or interhemispheric approach for butterfly glioma resection met inclusion criteria. A unilateral transcortical approach was used in 86% of cases and an interhemispheric approach in 14%. The endoscope enhanced the visualization of the contralateral hemisphere and allowed for resection of tumor, not reached by standard microscopic visualization, in 100% of cases. 90% of resections resulted in greater than a 95% resection rate. Neurological deficits mostly consisted of motor (10%) and memory (6%) deficits and were most common with posterior tumors of the splenium. CONCLUSION: The endoscopic-assisted transcortical or interhemispheric approach for butterfly glioma resection is effective in achieving a greater than 95% resection with minimal complications. An angled approach allows careful maneuvering around complex anatomic structures and difficult corners, and should be examined further for its clinical benefits in a prospective manner.
PURPOSE: Gliomas that spread along the white matter tracts of the corpus callosum to both hemispheres have traditionally been considered surgically challenging largely due to the relative complexity of safely achieving complete resections. We present a series of endoscopic-assisted resections of butterfly gliomas with post-operative radiological assessment of EOR and clinical outcome data. METHODS: Retrospective review of patients who underwent surgical resection of a butterfly glioma from 2007 to 2020. Butterfly gliomas were defined as gliomas, which appeared to arise from the corpus callosum with significant bilateral extension. All records were retrospectively reviewed with operative/clinical outcomes and complications recorded. RESULTS: 70 patients who underwent an endoscopic-assisted transcortical or interhemispheric approach for butterfly glioma resection met inclusion criteria. A unilateral transcortical approach was used in 86% of cases and an interhemispheric approach in 14%. The endoscope enhanced the visualization of the contralateral hemisphere and allowed for resection of tumor, not reached by standard microscopic visualization, in 100% of cases. 90% of resections resulted in greater than a 95% resection rate. Neurological deficits mostly consisted of motor (10%) and memory (6%) deficits and were most common with posterior tumors of the splenium. CONCLUSION: The endoscopic-assisted transcortical or interhemispheric approach for butterfly glioma resection is effective in achieving a greater than 95% resection with minimal complications. An angled approach allows careful maneuvering around complex anatomic structures and difficult corners, and should be examined further for its clinical benefits in a prospective manner.
Authors: Timothy Uschold; David S Xu; David A Wilson; Adib A Abla; Peter Nakaji; Robert F Spetzler; Steve W Chang Journal: World Neurosurg Date: 2013-10-16 Impact factor: 2.104
Authors: Fara Dayani; Jacob S Young; Alexander Bonte; Edward F Chang; Philip Theodosopoulos; Michael W McDermott; Mitchel S Berger; Manish K Aghi Journal: Neurosurg Focus Date: 2018-06 Impact factor: 4.047
Authors: M Lacroix; D Abi-Said; D R Fourney; Z L Gokaslan; W Shi; F DeMonte; F F Lang; I E McCutcheon; S J Hassenbusch; E Holland; K Hess; C Michael; D Miller; R Sawaya Journal: J Neurosurg Date: 2001-08 Impact factor: 5.115
Authors: Roger Stupp; Warren P Mason; Martin J van den Bent; Michael Weller; Barbara Fisher; Martin J B Taphoorn; Karl Belanger; Alba A Brandes; Christine Marosi; Ulrich Bogdahn; Jürgen Curschmann; Robert C Janzer; Samuel K Ludwin; Thierry Gorlia; Anouk Allgeier; Denis Lacombe; J Gregory Cairncross; Elizabeth Eisenhauer; René O Mirimanoff Journal: N Engl J Med Date: 2005-03-10 Impact factor: 91.245
Authors: Joshua D Burks; Phillip A Bonney; Andrew K Conner; Chad A Glenn; Robert G Briggs; James D Battiste; Tressie McCoy; Daniel L O'Donoghue; Dee H Wu; Michael E Sughrue Journal: J Neurosurg Date: 2016-09-16 Impact factor: 5.408
Authors: Rafał Chojak; Marta Koźba-Gosztyła; Katarzyna Słychan; Daniel Gajos; Marek Kotas; Michał Tyliszczak; Bogdan Czapiga Journal: Sci Rep Date: 2021-07-06 Impact factor: 4.379
Authors: Paolo Palmisciano; Gianluca Ferini; Gina Watanabe; Christian Ogasawara; Emal Lesha; Othman Bin-Alamer; Giuseppe E Umana; Kenny Yu; Aaron A Cohen-Gadol; Tarek Y El Ahmadieh; Ali S Haider Journal: Cancers (Basel) Date: 2022-05-19 Impact factor: 6.575
Authors: Robert G Briggs; Isabella M Young; Nicholas B Dadario; R Dineth Fonseka; Jorge Hormovas; Parker Allan; Micah L Larsen; Yueh-Hsin Lin; Onur Tanglay; B David Maxwell; Andrew K Conner; Jordan F Stafford; Chad A Glenn; Charles Teo; Michael E Sughrue Journal: Brain Behav Date: 2022-06-22 Impact factor: 3.405