Technique of Localizing the Central Sulcus under Awake Anesthesia for Treatment of Gliomas in or near Motor Areas

Özet

AIM: To study the protective effect on motor function of intraoperative awakening and localizing the central sulcus during surgery inpatients with gliomas located in motor areas.MATERIAL and METHODS: A total of 68 patients with gliomas in motor areas were intubated with a laryngeal mask andrapidly underwent craniotomy without scalp clips and with surgical awakening, followed by localization of the central sulcus bysomatosensory evoked potential. To protect brain function, we resected the greatest degree of tumor possible, and then finished byclosing the skull with the patient in an awake state or under general anesthesia.RESULTS: All the patients underwent surgery successfully. Except for the emergence of new neurological dysfunction in six patients,most patients’ neurological function did not deteriorate, or even showed improvement. In addition, there were no complicationsor postoperative painful memories for the patients. The resection of gliomas in motor areas with intraoperative awakening andlocalization of the central sulcus can ensure the largest possible resection of the tumor while protecting brain function.CONCLUSION: Here, we describe a simple and effective surgical procedure for patients with glioma. The technique involveslocalizing the central sulcus under awake anesthesia, which can improve the prognosis for patients with gliomas in motor areas.