Updated incidence of neurological deficits following insular glioma resection

A systematic review and meta-analysis

Victor M. Lu, Anshit Goyal, Alfredo Quinones-Hinojosa, Kaisorn L. Chaichana

Research output: Contribution to journalReview article

Abstract

The resection of insular gliomas remains a neurosurgical challenge due to the close proximity of functionally-important cortical, white matter tracts, and vasculature structures. More recently, the feasibility of resection has gained traction, however, there is a lack of consolidated neurological deficit metrics. Thus, the aim of this study was to determine the incidences of neurological deficits following insular glioma resection to better guide selection algorithms and resource allocations. Searches of seven electronic databases from inception to August 2018 were conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Data were extracted and pooled using meta-analysis of proportions. Meta-regression was used to identify potential sources of heterogeneity. Nineteen observational studies reported the neurological outcomes of 890 insular glioma patients. The pooled incidences of new temporary and permanent motor deficits were 11% (95% CI, 6–17%) and 4% (95% CI, 2–7%) respectively, and new temporary and permanent language deficits were 11% (95% CI, 6–17%) and 2% (95% CI, 0–4%) respectively. Single-surgeon series reported significantly lower incidences of both permanent motor (2% vs 7%; P < 0.001) and language (1% vs 3%; P = 0.03) deficits. The incidences of motor and language neurological deficits following insular glioma resection have been quantified, and will assist in determining the suitability and appropriateness of pursuing surgical resection for insular glioma. We note that permanent neurological deficits are lowest when reported by series describing outcomes of a single surgeon, indicating most optimal outcomes may be best achieved after intense training and/or greater experience.

Original languageEnglish (US)
Pages (from-to)20-26
Number of pages7
JournalClinical Neurology and Neurosurgery
Volume177
DOIs
StatePublished - Feb 1 2019

Fingerprint

Glioma
Meta-Analysis
Incidence
Language
Resource Allocation
Traction
Observational Studies
Databases
Guidelines
Surgeons

Keywords

  • Insular glioma
  • Language deficit
  • Motor deficit
  • Neurological deficit
  • Resection
  • Single surgeon

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Updated incidence of neurological deficits following insular glioma resection : A systematic review and meta-analysis. / Lu, Victor M.; Goyal, Anshit; Quinones-Hinojosa, Alfredo; Chaichana, Kaisorn L.

In: Clinical Neurology and Neurosurgery, Vol. 177, 01.02.2019, p. 20-26.

Research output: Contribution to journalReview article

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