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Surgical strategy for insular glioma
Colin J Przybylowski1, Shawn L Hervey-Jumper2, Nader Sanai3
1Department of Neurosurgery, Ivy Brain Tumor Research Center, Barrow Neurological Institute, Phoenix, AZ, USA.
Journal of Neuro-Oncology
|February 21, 2021
Summary
Maximal safe resection of insular gliomas improves survival. Strategies integrating anatomy, mapping, and technique minimize surgical risks, with transcortical approaches favored for posterior insular tumors.
Area of Science:
- Neurosurgery
- Oncology
- Neuroanatomy
Background:
- Insular gliomas present unique surgical challenges due to their location.
- Understanding insular anatomy and glioma biology is crucial for surgical planning.
Purpose of the Study:
- To review surgical outcomes for insular gliomas.
- To discuss strategies for minimizing postoperative morbidity in insular glioma surgery.
Main Methods:
- Literature review focusing on insular gliomas.
- Analysis of glioma biology, insular anatomy, and surgical techniques.
Main Results:
- Maximal safe resection is linked to improved survival for insular gliomas.
- Protecting speech and motor function requires integrating anatomy, cortical mapping, and microsurgical techniques.
- Transcortical and transsylvian approaches have low morbidity; transcortical with mapping is preferred for posterior insular gliomas.
Conclusions:
- Surgical strategy for insular gliomas is multifactorial, considering biological, anatomical, and clinical aspects.
- Optimizing surgical outcomes depends on technical skill and intraoperative technology integration.
