Clinical Trial on the Results of Insular Tumor Excision

Abstract

The insular cortex, located in the lateral sulcus of the brain, is a challenging area for neuro-oncology surgery. Successful removal of these tumors improves survival but can lead to impaired neurological function. Patients often experience minor focal impairments, such as seizures or headaches. The insular area is considered a nonsurgical entity due to the risks associated with surgical resection. A study of 62 patients with insular tumors found that awake resection delivered a comparable or superior degree of resection than asleep resection. However, the study also found that post-operative deficits were similar in both awake and asleep subgroups at 6 months. Neurocognitive function showed a tendency for a larger percentage of patients to decline in their fluency, verbal, and visual working memory. However, postoperative mental speed, attention, inhibition, planning, and learning memory improved in 3.8% of patients. These findings highlight the importance of understanding surgical anatomy, microsurgical procedures, imaging guidance, and cortical and subcortical mapping in achieving full resection in the insular area.