Phoniatric management in cerebral language mapping under awake craniotomy condition

• Main Authors: Ana Nasarre Alvaro Gracia, Nuria Esther Melián Cruz, Cristina García Fernández, Almudena Fernández Bravo Rueda, Carmelo Fernández García
• Format: Article
• Language: Spanish
• Published: Ediciones Universidad de Salamanca 2018-10-01
• Series: Revista ORL
• Subjects: awake brain surgery, cortical mapping, brain mapping, language.
• Online Access: https://revistas.usal.es/index.php/2444-7986/article/view/19352

<p>Introduction: Intraoperative cortical mapping in gliomas improves survival as it is associated to more extensive tumor resection and fewer neurological deficits. </p><p>The phoniatrician has the aim of assessing language before, during and after the surgery and indicating the appropriate therapy.</p><p>Material and methods: A descriptive study that includes all patients that have been operated from brain tumorresection with awake craniotomy, and have been assessed by the Phoniatrics Area of a Tertiary referral hospital from 204 to 2018. </p><p>Grade of participation and language are assessed in the first visit. Furthermore, exercises to be done during surgery are practiced by the patient: Number counting, Boston naming test, Token test, word repetition and image description. </p><p>The remaining language areas are assessed with the aphasia Boston Test.</p><p>During language mapping and tumor resection, the patient must perform the same tests. Whenever an error is detected, the neurosurgeon is informed.</p><p>One week and three weeks after the surgery, the patient undergoes the same assessment. If language impairment is noticed, speech therapy is started.</p><p>Results: 11 patients diagnosed of brain tumor with magnetic resonance. </p><p>One patient is ineligible because of severe language impairment and 4 patients have mild language impairment. At the postoperative period, 6 patients without previous language disorder, remain with unaffected language. 4 patients have aphasia, so speech therapy is started, reporting improvement in 3 patients.</p><p>Conclusion: Phoniatric management in awake brain tumor surgery allows detecting eligible patients for language mapping during the surgery and getting maximum tumor resection with minimum deficits.</p><p>When language disorders occur, phonatric intervention focuses on restoring language function.</p>