Comparative review of transcortical and trans-Sylvian approaches for surgical resection of giant insular gliomas: outcomes and challenges

Abstract The giant insular glioma is defined as occupying all zone of the insula according to the Berger-Sanai classification. It is often encountered with a large volume, extending to the surrounding areas, functional pathway, and vascular structure, making its surgical resection very challenging f...

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Main Authors: Maman Roufai Hamissou Moussa, Rafeq Agila
Format: Article
Language:English
Published: SpringerOpen 2025-02-01
Series:Egyptian Journal of Neurosurgery
Subjects:
Online Access:https://doi.org/10.1186/s41984-025-00370-4
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author Maman Roufai Hamissou Moussa
Rafeq Agila
author_facet Maman Roufai Hamissou Moussa
Rafeq Agila
author_sort Maman Roufai Hamissou Moussa
collection DOAJ
description Abstract The giant insular glioma is defined as occupying all zone of the insula according to the Berger-Sanai classification. It is often encountered with a large volume, extending to the surrounding areas, functional pathway, and vascular structure, making its surgical resection very challenging for a neurosurgeon. In the literature, some studies revealed that it is more likely not to achieve a great extent of resection and is associated with a high postoperative morbidity rate. However, those studies included different insular gliomas regarding the location, extension, and surgical approach addressed. The giant insular gliomas subtype has been reported in the literature combined with all the insular gliomas and different surgical methods, which may bias the outcomes. The main approaches for insular glioma surgery are transcortical (TC) and trans-Sylvian (TS) approaches. This review aims to evaluate the evidence supporting the use of TS and TC surgical approaches for the management of giant insular gliomas. It will also analyze the associated postoperative outcomes to provide insights into their effectiveness and safety.
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institution Kabale University
issn 2520-8225
language English
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series Egyptian Journal of Neurosurgery
spelling doaj-art-944f0a09d607459c9610006efb5d14022025-02-09T12:25:12ZengSpringerOpenEgyptian Journal of Neurosurgery2520-82252025-02-014011610.1186/s41984-025-00370-4Comparative review of transcortical and trans-Sylvian approaches for surgical resection of giant insular gliomas: outcomes and challengesMaman Roufai Hamissou Moussa0Rafeq Agila1Department of Neurosurgery, Armed Forces HospitalDepartment of Neurosurgery, West China Hospital, Sichuan UniversityAbstract The giant insular glioma is defined as occupying all zone of the insula according to the Berger-Sanai classification. It is often encountered with a large volume, extending to the surrounding areas, functional pathway, and vascular structure, making its surgical resection very challenging for a neurosurgeon. In the literature, some studies revealed that it is more likely not to achieve a great extent of resection and is associated with a high postoperative morbidity rate. However, those studies included different insular gliomas regarding the location, extension, and surgical approach addressed. The giant insular gliomas subtype has been reported in the literature combined with all the insular gliomas and different surgical methods, which may bias the outcomes. The main approaches for insular glioma surgery are transcortical (TC) and trans-Sylvian (TS) approaches. This review aims to evaluate the evidence supporting the use of TS and TC surgical approaches for the management of giant insular gliomas. It will also analyze the associated postoperative outcomes to provide insights into their effectiveness and safety.https://doi.org/10.1186/s41984-025-00370-4Insular gliomasExtent of resectionTranscortical approachTrans-Sylvian approachPostoperative complications
spellingShingle Maman Roufai Hamissou Moussa
Rafeq Agila
Comparative review of transcortical and trans-Sylvian approaches for surgical resection of giant insular gliomas: outcomes and challenges
Egyptian Journal of Neurosurgery
Insular gliomas
Extent of resection
Transcortical approach
Trans-Sylvian approach
Postoperative complications
title Comparative review of transcortical and trans-Sylvian approaches for surgical resection of giant insular gliomas: outcomes and challenges
title_full Comparative review of transcortical and trans-Sylvian approaches for surgical resection of giant insular gliomas: outcomes and challenges
title_fullStr Comparative review of transcortical and trans-Sylvian approaches for surgical resection of giant insular gliomas: outcomes and challenges
title_full_unstemmed Comparative review of transcortical and trans-Sylvian approaches for surgical resection of giant insular gliomas: outcomes and challenges
title_short Comparative review of transcortical and trans-Sylvian approaches for surgical resection of giant insular gliomas: outcomes and challenges
title_sort comparative review of transcortical and trans sylvian approaches for surgical resection of giant insular gliomas outcomes and challenges
topic Insular gliomas
Extent of resection
Transcortical approach
Trans-Sylvian approach
Postoperative complications
url https://doi.org/10.1186/s41984-025-00370-4
work_keys_str_mv AT mamanroufaihamissoumoussa comparativereviewoftranscorticalandtranssylvianapproachesforsurgicalresectionofgiantinsulargliomasoutcomesandchallenges
AT rafeqagila comparativereviewoftranscorticalandtranssylvianapproachesforsurgicalresectionofgiantinsulargliomasoutcomesandchallenges