Pirogov National Medical Surgical Center, Moscow, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2023;87(1):5-14. doi: 10.17116/neiro2023870115.
After surgical treatment of tumors of the supplementary motor area (SMA) post-operative speech and/or motor neurological deficit may occur.
To determinate frequency and reversibility of such deficit and identify risk factors for its development.
We retrospectively analyzed postoperative outcomes in 34 patients with SMA tumors. Pre- and postoperative neurological status, localization of tumors, extent of resection relative to adjacent regions and relationship of tumor with white matter tracts were assessed. We also analyzed the influence of these factors on the risk of postoperative neurological impairment.
Postoperative neurological impairment occurred in 47% of cases. Complete or significant regression was observed in all patients within 5.7 month after surgery. Major risk factors were lesion of dominant hemisphere (=0.029), tumor spreading to primary motor cortex (=0.018) and resection of SMA together with cingulate gyrus (=0.000). Location of frontal aslant tract in dominant hemisphere just near the tumor contributed to disorders regarding speech initiation and fluency (=0.016). Resection of SMA with cingulate gyrus in dominant hemisphere affected development of more serious speech disorders (=0.003).
Surgery for SMA tumors is safe and followed by favorable functional outcomes.
手术后辅助运动区 (SMA) 的肿瘤可能会出现言语和/或运动神经功能缺损。
确定这种缺陷的频率和可逆性，并确定其发展的危险因素。
我们回顾性分析了 34 例 SMA 肿瘤患者的术后结果。评估了术前和术后的神经状态、肿瘤的定位、与相邻区域的切除范围以及肿瘤与白质束的关系。我们还分析了这些因素对术后神经损伤风险的影响。
术后神经功能障碍发生在 47%的病例中。所有患者在术后 5.7 个月内均出现完全或显著缓解。主要危险因素是优势半球的病变（=0.029）、肿瘤向初级运动皮层扩散（=0.018）和 SMA 与扣带回切除术（=0.000）。优势半球额斜束在肿瘤附近的位置与言语起始和流畅性障碍有关（=0.016）。优势半球 SMA 与扣带回切除术影响更严重的言语障碍的发展（=0.003）。
SMA 肿瘤的手术安全，功能预后良好。
