Frontal operculum gliomas: language outcome following resection

Document Type

Article

Abstract

OBJECT: The dominant hemisphere frontal operculum may contain critical speech and language pathways, and due to these properties, patients with tumors of the opercular region may be at higher risk for postoperative speech dysfunction. However, the likelihood of incurring temporary or permanent language dysfunction is unknown. METHODS: The authors retrospectively analyzed their cohort of patients with frontal gliomas to identify those tumors that predominantly involved the dominant frontal operculum. Each tumor was classified as involving the pars orbitalis, pars triangularis, pars opercularis, or a combination of some or all of these areas. The authors then identified and compared characteristics between those patients experiencing transient or permanent speech deficits, as opposed to those with no language dysfunction. RESULTS: Forty-three patients were identified for inclusion in this analysis. Transient deficits occurred in 12 patients (27.9%), while 4 patients (9.8%) had persistent deficits involving language. Individuals with preoperative language deficits and patients with seizures characterized by speech dysfunction appear to be at the highest risk to develop a deficit (relative risks 3.09 and 1.75, respectively). No patient with a tumor involving the pars orbitalis experienced a persistent deficit. CONCLUSIONS: Resection of gliomas is widely recognized as a critical element of improved outcome. Given the low rate of language morbidity reported in this group of patients, resection of gliomas within the dominant frontal operculum is well-tolerated with acceptable morbidity and, in this particular location, should not be a deterrent in the overall management of these tumors.

Medical Subject Headings

Adult; Aged; Brain Mapping; Brain Neoplasms (pathology, surgery); Cohort Studies; Female; Frontal Lobe (pathology, surgery); Glioma (pathology, surgery); Humans; Language Disorders (etiology, psychology); Magnetic Resonance Imaging; Male; Middle Aged; Neuroimaging; Neurosurgical Procedures (adverse effects, methods); Postoperative Complications (psychology); Retrospective Studies; Young Adult

Publication Date

4-1-2015

Publication Title

Journal of neurosurgery

E-ISSN

1933-0693

Volume

122

Issue

4

First Page

725

Last Page

34

PubMed ID

25635477

Digital Object Identifier (DOI)

10.3171/2014.11.JNS132172

Link to Full Text

Share

COinS