Operative Neurosurgery 28:478–486, 2025
This study presents a transtemporal isthmus approach for insular glioma surgery, achieving maximal safe resection. This method utilizes a widened temporal isthmus to access the insular lobe, ensuring significant tumor removal while preserving neurological function. The approach is shown effective for both low- and high-grade gliomas.
• The study introduces a transtemporal isthmus approach for the resection of insular gliomas, aiming for maximal and safe tumor removal.
• This surgical method involves the use of MRI and functional neuronavigation guidance, along with intraoperative electrophysiological monitoring.
• The approach is particularly beneficial for tumors involving zones III and IV of the Berger-Sanai classification.
• Gross total resection was achieved in 64.9% of low-grade and 87.5% of high-grade gliomas.
• The temporal isthmus is widened by the tumor, providing a surgical corridor for resection.
• The median postoperative Karnofsky performance score was 90, indicating good functional preservation.
• Muscle strength and speech were nearly normal in all patients three months post-surgery.
• The study suggests this approach is effective for safe and maximal tumor resection, while preserving essential functions.
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