Abstract
Tumors in primary sensory area are challenging to remove without causing a neurological deficit, especially in musicians who present complex neuronal networks. Indeed, in this kind of patients, somatosensory evoked potentials (SSEPs) are not plenty. We describe our experience for sensory and proprioception preservation in a professional clarinet player undergoing surgery for a right parietal glioblastoma. The patient underwent surgery for a right parietal glioblastoma. Intraoperative monitoring and awake surgery while playing instrument, were performed. During resection, intraoperative stimulation caused a transient impairment of left hand movements, without SSEPs alteration. The resection was stopped anytime there was a movement impairment. We obtained a gross total tumor resection. Patient did not present neurological deficits. Standard neurophysiological monitoring is fundamental but cannot be sufficient. More complex strategies of monitoring, such as awake surgery and playing an instrument could be of help for preserving complex sensory-motor functions.
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Video 1: tumor resection is ongoing under continuous stimulation and neurophysiological monitoring. During stimulation of the posterior part of the surgical field, patient complaints left hand movement impairment. Once the stimulation is stopped, the disturbance disappears and she restarts playing correctly. SEPs did not present any change. (MP4 24167 kb)
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Scerrati, A., Mongardi, L., Cavallo, M.A. et al. Awake surgery for skills preservation during a sensory area tumor resection in a clarinet player. Acta Neurol Belg 121, 1235–1239 (2021). https://doi.org/10.1007/s13760-020-01368-5
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DOI: https://doi.org/10.1007/s13760-020-01368-5