Transfrontal isthmus approach:a new surgical technique for insular glioma
SUN Guochen
WU Dongdong
ZHAO Kai
CHENG Gang
SHU Xujun
CONG Xiaojun
ZHOU Xingyu
LI Yanteng
ZHANG Jianning
Abstract：Objective To introduce a new approach for insular glioma surgery and explore the possibility of the safe removal of insular glioma to the greatest extent.Methods Patients with insular glioma admitted to the First Medical Center of the PLA General Hospital were enrolled,all of whom underwent surgery through the frontal isthmus approach.The extent of tumor resection and functional preservation rate were analyzed.Results A total of 39 patients were included in the study,including 24 men and 15women,with an average age of 40.7 years old.According to the Berger-Sanai classification system,all enrolled patients were involved in at least ZoneⅠ,with giant glioma being the most common(65.3%),followed byⅠ+Ⅳ(21.7%).According to the classification of yasargil,there were 15 cases of type 3B and 24 cases of type 5A/B.There were 9 cases with putamen involvement,and 30 cases without putamen involvement.The median tumor volume and interquartile range(IQR)were 56.4(43.7,81.3)mL before surgery,and 17(60.7%)of the 28 LGGs achieved complete resection.Of the 11 HGGs,10 patients(90.9%)got total resection.All patients had muscle strength above grade 4,and exhibited nearly normal speech at the 3-month follow-up examination.The median postoperative KPS at 3 months postoperatively was 90(IQR 80-90).Conclusions The frontal isthmus approach changes the working angle,which has an advantage over the resection of the ZoneⅡ,and can achieve the maximum safe resection of insular glioma.
Keywords：Insular lobeGliomaIsthmusSurgery
Publication Date：2025-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 38-43 )