Efficacy Analysis Of Microsurgical Treatment Of Insular Gliomas

Purpose:Discuss the microsurgical treatment effect of insular gliomas through retrospective analysis of previous cases.Methods:A retrospective analysis was conducted on the clinical diagnosis and treatment of 21 cases of insular gliomas.The insular gliomas were classified based on preoperative MRI and CT scans into four categories:pure insular tumors(7cases),insular-frontal tumors(2 cases),temporo-insular tumors(2 cases),and orbito-insular-temporal tumors(10 cases).The tumors were then removed through pterional approach or amplification pterional approach under a microscope,depending on their location and invasive extent.Postoperative MRI follow-up and intraoperative microscopic observation were performed to evaluate the tumor resection rate.Compare the differences in KPS scores between patients within 3 days and 1 month after surgery.In addition,the remission rate of clinical symptoms in patients one month after surgery was compared.Evaluate the effectiveness of surgery through statistical analysis.Results:Postoperative MRI showed complete resection in 9 cases,subtotal resection in 12 cases,and no surgical deaths.Pathological examination revealed 11 cases of astrocytoma,4 cases of diffuse astrocytoma,3 cases of oligodendroglioma,and 3cases of glioblastoma.Of the 21 patients,14 experienced varying degrees of contralateral limb muscle weakness(after symptomatic treatment after surgery,1fully recovered,10 significantly improved after symptomatic treatment,and 3showed no improvement).Four patients experienced language function disorders(3had motor aphasia,of which 2 significantly improved after symptomatic treatment and 1 improved but with limited vocabulary;1 had sensory aphasia,which recovered after surgery).One patient developed postoperative residual hematoma and underwent emergency"craniotomy for hematoma removal+decompressive craniectomy"with good postoperative recovery and no complications.One patient developed cognitive impairment,but showed no significant improvement after rehabilitation therapy.The KPS score of 21 patients with insular gliomas within 3days after surgery was(71.52±12.44)points,and the KPS score within 1 month after surgery was(80.95±13.38)points,with a statistically significant difference(P<0.05).Compared with preoperative patients one month after surgery,the improvement rate of 14 epilepsy patients was 64.3%,which was statistically significant by X~2 test(P<0.05);The improvement rate of 19 patients with high intracranial pressure symptoms was 84.2%,which was statistically significant by X~2test(P<0.05);The improvement rate of 10 patients with hemiplegia or sensory impairment was 40%,and there was no statistically significant difference in X~2test(P>0.05);The improvement rate of 5 patients with memory loss was 20%,and there was no statistically significant difference in X~2 test(P>0.05).Follow-up of the 21cases for 6-24 months showed 1 death and 6 relapses.Conclusion:Through the clinical presentation of patients and the assistance of imaging such as CT and MRI,the location of the tumor and its relationship with surrounding tissues can be determined.This further enables the classification of the tumor,followed by the selection of appropriate surgical methods.By using auxiliary techniques such as microscopy,the maximum amount of lesion tissue can be removed while minimizing intraoperative nerve damage,thereby improving the quality of life and extending the survival time of patients.