Since 2010, surgical resection of insular gliomas is performed via transopercular approach by the Neurosurgery Clinic, Istanbul Training and Research Hospital, Departments of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Turkey.
Clinical, surgical and follow-up results were analyzed retrospectively.
The majority were low-grade (81.8%) and among them oligodendroglioma was the most common (n = 8). Half of the patients underwent awake craniotomy with cortical electrostimulation and total resection was achieved in 6 patients. Long-term follow-up showed the majority of patients (90.9 %) were completely seizure free. Only one patient showed slight paresis on one upper extremity at the long-term follow-up.
Trans-opercular approach for insular gliomas is safe and maximal resection with minimal neurological deficits is possible. Use of ultrasonic aspirator and neuronavigation make surgery safer. Surgery-related complication is very rare. Future studies should contain larger number of patient and long-term follow-up in order to provide more accurate data 1).