经外侧裂-岛叶切除岛叶胶质瘤手术入路的显微解剖学研究OACSTPCD

Objective By simulating the relevant anatomical structure of the lateral fissure-insular lobe through the cadaver head specimen,it can provide reference for clinicians to carry out insular gliomas resection,thereby improving the total tumor resection rate while maximizing the protection of brain tissue function.Methods Anatomical study of lateral fissure,insular lobe,and middle cerebral artery regions on 10 cadaveric head specimens were conducted.The relationship among the important structures were observed by taking photos,and the relevant parameters were measured.Results The central sulcus of the island was parallel to the central sulcus on the surface of the brain,which divides the insular lobe into the front half and the back half.The front half consists of 3 to 5 short insular gyri,the back half consists of 2 long insular gyri.The front half of insular lobe was covered by the trigone of the inferior frontal gyrus,the tectum and the anterior central gyrus.The upper part of the back half of the insular lobe was covered by the posterior central gyrus,the supramarginal gyrus,and the lower part was covered by the heschl's gyrus.The insular lobe was surrounded by the upper longitudinal bundle,which connects the frontotemporal parietal occipital lobe,and the uncinate bundle connects the frontal lobe and temporal lobe below the insular lobe.When exposed through the lateral fissure to reach the upper boundary sulcus area and the anterior island point,the fronto orbital region should be pulled for at least 2.0 cm to avoid damage to Broca region.To expose the inferior border sulcus of the insular lobe,it is necessary to pull the temporal lobe by 2.5 cm,and pay attention to avoid damaging the transverse temporal gyrus during the process of traction and compression.Conclusion The lateral temporal-insular lobe could fully expose the insular lobe,which is suitable for resection of pure insular gliomas.For other types of insular gliomas,the anterior point and anterior boundary sulcus are easy to be exposed,while the posterior point and lower boundary sulcus are more difficult to be exposed.