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Abstract: Background: Advances in the oncological and functional results of insular surgery have been reported recently. Such successes have been made possible by the advent of the transopercular approach under awake monitoring and by the improved anatomical and functional knowledge of the white matter pathways surrounding the insula. Nonetheless, given the rarity of insular tumors, it is difficult to get familiar with the complex 3D anatomy of the different neuronal and vascular structures encountered during a transopercular insular resection. We thus propose to develop a laboratory model allowing to train transopercular approaches of the insula Methods Two hemispheres prepared with Klinger's technique were dissected under light microscope, preserving all pial membranes. The different steps of the dissection were video recorded. Results The preservation of pial membranes enabled to simulate subpial resection, both during operculum removal and during insular cortex resection. The medial wall of the resection was defined by the inferior-fronto-occipital fasiculus, protecting from the lenticulostriate arteries. Conclusion In this paper, we show that Klinger dissection with preservation of pial membranes provides a realistic model of insular surgery, allowing to learn and train this highly-specialized surgery.
Fuente: World Neurosurgery, 2017, 98, 239-242
Publisher: Elsevier
Year of publication: 2017
No. of pages: 12
Publication type: Article
DOI: 10.1016/j.wneu.2016.10.020
ISSN: 1878-8750,1878-8769
Consult in UCrea Read publication
MANDONNET, EMMANUEL
JUAN MARTINO GONZALEZ
SARUBBO, SILVIO
CORRIVETTI, FRANCESCO
BOUAZZA, SCHAHRAZED
BRESSON, DAMIEN
DUFFAU, HUGUES
FROELICH, SEBASTIEN
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