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 OPERATIVE NUANCES: STEP BY STEP (VIDEO SECTION)
Year : 2022  |  Volume : 70  |  Issue : 2  |  Page : 520--523

Transopercular Approach to Resection of Dominant Hemisphere Diffuse Insular Glioma Using Multimodal Intraoperative Strategy with Awake Mapping


Department of Surgical Oncology, Division of Neurosurgery, Tata Memorial Centre, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Aliasgar V Moiyadi
Division of Neurosurgery, Department of Surgical Oncology, Tata Memorial Centre, Dr. E. Borges Road, Parel, Mumbai - 400 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.344621

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Background: Deep location as well as relation to major vascular structures and eloquent brain areas make insular glioma resection challenging. Transsylvian and transopercular approaches have been described for resection of these tumors. Objective: We illustrate the anatomical relations of a dominant hemisphere insular glioma and present the video demonstrating the step-wise resection of the same via frontal transopercular approach. Surgical Procedure: A 27-year-old lady with dominant hemisphere insular glioma underwent awake surgery through a transopercular approach with cortical and subcortical mapping using direct electrical stimulation for resection of the same. Result: Gross total resection of left insular glioma was achieved without any fresh postoperative deficits. Conclusion: Awake transopercular approach with intraoperative motor, language, and neuropsychological monitoring helps achieve maximum safe resection of insular glioma in the dominant cerebral hemisphere.






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Online since 20th March '04
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