CORTICAL LOCALIZATION OF TEMPORAL-LOBE LANGUAGE SITES IN PATIENTS WITH GLIOMAS
CORTICAL LOCALIZATION OF TEMPORAL-LOBE LANGUAGE SITES IN PATIENTS WITH GLIOMAS
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DOI：
10.1227/00006123-199404000-00001
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发表时间：
1994-04-01
期刊：
影响因子：
4.8
通讯作者：
OJEMANN, GA
中科院分区：
文献类型：
--
作者：
HAGLUND, MM;BERGER, MS;OJEMANN, GA
在一系列40例接受清醒开颅手术切除优势半球颞叶胶质瘤的患者中，皮质刺激标测被用于定位基本语言部位。这些部位定位于不同的颞叶部分，并与83例接受语言映射治疗顽固性癫痫的无肿瘤患者进行比较。在有和没有颞叶胶质瘤的患者中，上级颞回比颞中回包含更多的语言位点。两个患者人群的语言位点也位于上级颞回中央沟前方（12-16%）。与颞叶肿瘤患者的上级颞回相比，无肿瘤患者的上级颞回有更多的语言位点。研究了多个变量对术前和术后语言缺陷的影响，包括年龄、性别、语言部位数量、组织学、肿瘤大小以及肿瘤切除边缘与最近语言部位的距离。切除边缘与最近语言部位的距离是确定术前语言缺陷改善、术后语言缺陷持续时间以及术后语言缺陷是否为永久性的最重要变量。如果切除边缘距离最近的语言部位> 1 cm，则发生永久性语言障碍的情况明显较少。皮质刺激映射识别的主要半球颞叶胶质瘤患者的基本语言网站将最大限度地扩大肿瘤切除的范围，并尽量减少永久性语言障碍。
IN A SERIES of 40 patients undergoing an awake craniotomy for the removal of a glioma of the dominant hemisphere temporal lobe, cortical stimulation mapping was used to localize essential language sites. These sites were localized to distinct temporal lobe sectors and compared with 83 patients without tumors who had undergone language mapping for the treatment of intractable epilepsy. In patients with and without temporal lobe gliomas, the superior temporal gyrus contained significantly more language sites than the middle temporal gyrus. Both patient populations also had language sites anterior to the central sulcus in the superior temporal gyrus (12-16%). The patients without tumors had significantly more language sites in the superior temporal gyrus, compared with the superior temporal gyrus of patients with temporal lobe tumors. Multiple variables were studied for their effect on preoperative and postoperative language deficits and included age, sex, number of language sites, histology, size of the tumor, and the distance of tumor resection margins from the nearest language site. The distance of the resection margin from the nearest language site was the most important variable in determining the improvement in preoperative language deficits, the duration of postoperative language deficits, and whether the postoperative language deficits were permanent. If the distance of the resection margin from the nearest language site was > 1 cm, significantly fewer permanent language deficits occurred. Cortical stimulation mapping for the identification of essential language sites in patients with gliomas of the dominant hemisphere temporal lobe will maximize the extent of tumor resection and minimize permanent language deficits.