Gliomas da ínsula: revisão anatômica e sua correlação com a extensão da ressecção, morbidade e sobrevida

Abstract

Introduction: The insula has complex anatomy. The choice of transsylvian or transcortical corridors for resection of insular gliomas remains controversial, and the main concerns are vascular injury during transsylvian dissection and functional compromise in the transcortical approach. Objective: To review the anatomy of the insula and compare whether there is a difference between the extent of resection, postoperative morbidity and mortality, and survival between the 2 approaches. Method: Review carried out collecting information published on virtual platforms in Portuguese and English. Initially, a search was done for descriptors related to the topic “insula gliomas, brain mapping, transsylvian access, transcortical access, extent of resection and surgical technique”, with AND or OR search, considering the title and/or abstract. Afterwards, only those that were most related to the topic were included, and the texts were read in full. Finally, 87 articles were mentioned. Results: There was no difference between the transsylvian and transcortical approaches regarding the extent of resection, postoperative morbidity and survival. Conclusions: The discussion between the different schools of approach types is harmless, being more ideological, as they reflect the routine of different groups of neurosurgeons and is not based on statistical arguments.