Even the name is hard to pronounce. Glomus jugulare tumors sit in an anatomical jewel box in or around sigmoid sinus, jugular vein & bulb, petrous carotid artery, lower cranial nerves, facial nerve, and the labyrinthine of petrous bone. They may just be the most complex skull base tumors of them all…
In this operative video, Dr. Cohen demonstrates resection of a large left insular glioma through a frontotemporal transsylvian approach.
Tumor debulking is performed through the transsylvian corridor while preserving the MCA branches that define the operative field. As the resection advances near the distal M1 segment, the expected location of the lateral lenticulostriate arteries remains a critical anatomical consideration.
Working channels beneath the MCA branches allow continued tumor removal while limiting traction on normal brain. The fibrous frontal tissue is mobilized beneath the frontal operculum and drawn into the resection cavity, with suction used to gently displace adjacent brain and maintain the operative plane.
Review more Glioma operative cases through The Neurosurgical Atlas.
You’ve seen this surgery before. This approach to cavernomas in the central pons thru middle cerebellar peduncle is the workhorse for brainstem cavernomas: easy retrosigmoid craniotomy, well tolerated entry thru the peduncle. The challenge is seeing all the way around this large & deep cavity thru the tiny keyhole….
‘You know, if I did that, you just look like an utter c***, right? But somehow he does it, and it’s like, it's the greatest thing I’ve ever seen.’
Oasis: Don’t Look Back In Anger is available to stream on Disney+ and Hulu now!