Neurosurgical anatomy of the insula and Sylvian fissure: Literature review and personal experience. The third report. Anatomy of sylvian fissure, sylvian cistern, gyri and fissures of the insula

Valentyn M. Kliuchka; Artem V. Rozumenko; Volodymyr D. Rozumenko; Oleksandr M. Lisianyi; Tetyana A. Malysheva; Volodymyr Y. Shutka; Andrii V. Dashchakovskyi

doi:10.25305/unj.328419

Authors

Valentyn M. Kliuchka Department of Innovative Neurosurgical Technologies, Romodanov Neurosurgery Institute, Kyiv, Ukraine https://orcid.org/0000-0001-6025-7199
Artem V. Rozumenko Department of Innovative Neurosurgical Technologies, Romodanov Neurosurgery Institute, Kyiv, Ukraine https://orcid.org/0000-0003-0668-6659
Volodymyr D. Rozumenko Department of Innovative Neurosurgical Technologies, Romodanov Neurosurgery Institute, Kyiv, Ukraine https://orcid.org/0000-0002-8774-6942
Oleksandr M. Lisianyi Department of Innovative Neurosurgical Technologies, Romodanov Neurosurgery Institute, Kyiv, Ukraine https://orcid.org/0000-0002-9965-9993
Tetyana A. Malysheva Department of Neuropathomorphology, Romodanov Neurosurgery Institute, Kyiv, Ukraine https://orcid.org/0000-0003-4071-8327
Volodymyr Y. Shutka Department of Traumatology, Orthopedics and Neurosurgery, Bukovinian State Medical University, Chernivtsy, Ukraine https://orcid.org/0009-0008-1391-9485
Andrii V. Dashchakovskyi Department of Innovative Neurosurgical Technologies, Romodanov Neurosurgery Institute, Kyiv, Ukraine https://orcid.org/0000-0001-6675-9368

DOI:

https://doi.org/10.25305/unj.328419

Keywords:

insular gliomas, sylvian fissure, sylvian cistern, operculum, surgical anatomy of the insula

Abstract

Despite being a region where numerous pathological processes may develop, the insula remains one of the least studied anatomical structures of the human brain. The clinical course of insular glioma is accompanied by a severe morbidity, caused by the proximity of the central core, important projection and associative pathways, main arteries and large venous collectors. For a long time, surgery of patients with insular gliomas, which would involve the total volume tumor removal while ensuring high quality of post-surgery life, was considered impossible.

Understanding the surgical anatomy of the insula is key to successful transsylvian-transinsular, transopercular approaches to insular gliomas and their radical removal.

The article provides a detailed surgical anatomy of the sylvian fissure, the operculum and the insula.

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