Long-term clinical and seizure outcomes of insular gliomas via trans-opercular approach

Objective: To report long-term clinical and seizure outcomes of patients who were operated upon insular gliomas via trans-opercular approach. Patients and Methods: Since 2010, surgical resection of insular gliomas was performed via trans-opercular approach by our group. Clinical, surgical and follow-up results were analyzed retrospectively. Results: 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 electrical stimulation and total removal 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. Conclusions: 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.