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The aim of this literature review is to summarize techniques used to prevent postoperative visual pathway complications during parietal glioma resection involving optic radiations (OR), focusing on the use of virtual reality (VR) headset during awake patient surgery. We searched the Medline database for literature between the years of 1970 and 2021. Only results that included the use of AC for sensory mapping were included for evaluation. The search was limited to studies published in English and humans as subjects. Only studies that reported patient groups treated with either parietal glioma surgery under general anesthesia or awake conditions were included. Articles describing deep brain stimulation as the therapy were excluded. The variables initially selected for analysis included the length of surgery, length of hospital stay, extent of resection, cost, mortality, and neurological morbidity. Cost was later removed from the studied variables because too few studies reported it. No commentaries or reviews were included. Gliomas are the most common primary brain tumors located mainly in the cerebral cortex. 17% are found in the parietal lobe, which is a convergence area for multiple stimulus integration. After surgical resection of this lobe, patients may develop postoperative verbal, linguistic and visual field deficits. The gold standard treatment for these tumors is surgical resection. The main technique to preserve functional pathways is by intraoperative monitoring, for which different tools have been developed in the past years. Surgeons can test and preserve important tracts, such as the visual pathway. Intraoperative ultrasound has shown to be an excellent, accessible, and affordable intraoperative monitoring tool. Magnetic resonance imaging-based tractography and reality-based brain mapping allow not only intraoperative monitoring, but also create a preoperative plan by demarcating the structures and margins of the tumor prior to and during surgery, increasing success rate in maximum resection. |
