الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Insular gliomas management has faced challenges due to their complex shape, proximity to critical vasculature, functional significance, and organization of the insular cortex. However, recent advancements in cytoreductive surgery have highlighted the importance of maximal EOR in improving overall and progression-free survival.
The aim of this study was to assess the impact of using intraoperative ultrasound on the extent of resection of insular gliomas, and the postoperative outcomes.
This study included 20 patients diagnosed with insular gliomas who underwent surgical resection at the neurosurgery department of the Alexandria main university hospital.
The preoperative, postoperative, and 90-day follow-up assessment consisted of a general neurological examination, evaluation of KPS and imaging studies including CT-scans, T1, T2 and FLAIR MRI as well as volumetric assessment and Berger-Sanai classification. Intraoperative ultrasound guided resection was conducted in all patients under general anesthesia with surgical approach being surgeon and patient specific.
The mean age was 55.20 ±11.45 while 70% of patients were male. 55% of patients presented with seizures (n=11) and had a mean duration of symptoms of 2.0 ± 0.79 months.
The NTR rate was 45% with 70% of patients having no neurological morbidity postoperatively. The median EOR was 81% with a range of 44% to 96%. The mean ± SD duration of IOUS setup was 19.6 ± 5.04 minutes while the additional resection rate following IOUS assessment for residual tumor was 65% (n=13).