• Mingyu Zhang, Lei Huo, Junyu Wang, Zhiming Ma, Jiasheng Fang, Yihua Rao, Zeming Tan, and Zhenxing Zhang.
• Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha 410008, China.
• Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2009 Apr 1; 34 (4): 345-8.

ObjectiveTo explore the microsurgical techniques for insular glioma without damaging its surrounding normal structures.MethodsWe retrospectively analyzed 54 patients with insular gliomas who underwent microsurgical operation by trans-syvian fissure approach between May, 2003 and August, 2008 in Xiangya Hospital. We discussed the techniques in the operation and summarized how to protect the key blood vessels, distinguish and protect the surrounding normal structures.ResultsThere were 36 complete removals,14 secondary complete removals, and 4 partial removals.Six patients had complications after the craniotomy who had temporal speech disorder (aphasia mostly began to recover about 10 days after the craniotomy),4 patients had opposite side paralysis worsening (3 recovered normally and 1 improved after 6 months),4 had light paralysis, and another 3 had paralysis and speech disorder.ConclusionThe microsurgery by means of trans-syvian fissure approach can well expose the anatomical relation between tumor and its surrounding structures,so that we can remove the tumor and protect the surrounding normal tissues as much as we can.

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