How Is Glial Tumor Surgery Performed?

Glial tumor (glioma) is a type of tumor that develops from glial cells, which are the supporting cells of the brain. These tumors can occur in different areas within the brain tissue, may grow slowly or rapidly, and can affect neurological functions.
Prof. Dr. Ömür Günaldı emphasizes that glial tumor surgeries are among the most delicate and technically advanced procedures in neurosurgery, and that the surgical plan for each patient is prepared individually according to the tumor’s location, size, and stage.

Purpose of Glial Tumor Surgery

The main goal of glial tumor surgery is to remove as much of the tumor as possible while preserving the vital functions of the brain. Because the tumor is often embedded within brain tissue, surgery requires a careful balance between removing tumor cells and protecting healthy neural structures.

Prof. Dr. Ömür Günaldı states that the aim of surgery is not only to remove the tumor but also to preserve important functions such as speech, movement, memory, and vision.

Preoperative Preparation

The preoperative stage is one of the most critical phases of treatment. During this period, the patient’s neurological condition is evaluated, the location of the tumor is identified, and the surgical plan is created.

Imaging and Brain Mapping

• Magnetic Resonance Imaging (MRI): Used to determine the size and boundaries of the tumor.
• MR Spectroscopy: Provides information about the cellular structure of the tumor.
• Functional MRI (fMRI): Identifies brain areas responsible for speech, movement, and vision.
• Neuronavigation Planning: Digital mapping is prepared to guide the surgeon during the operation.

Prof. Dr. Ömür Günaldı explains that these data serve as a “road map” for the neurosurgeon, allowing the tumor to be removed with millimetric precision.

Patient Preparation

• Before surgery, anesthesia evaluation is performed, and tests such as blood analysis and ECG may be required.
• In some cases, the surgery may be performed using awake brain surgery (awake craniotomy). During this method, the patient may speak or perform movement tests while the surgical team monitors neurological functions.

How Is the Surgery Performed?

Glial tumor surgery is a procedure that uses the most advanced technologies in neurosurgery.
Prof. Dr. Ömür Günaldı summarizes the surgical steps as follows:

Anesthesia and Positioning

• The surgery is usually performed under general anesthesia, although in certain cases the patient may remain awake.
• The patient’s head is stabilized using a special fixation system to allow precise access to the surgical area.

Opening the Skull (Craniotomy)

• The surgeon creates an opening in the skull corresponding to the area where the tumor is located. This procedure is called a craniotomy.
• The removed bone segment is temporarily lifted and replaced at the end of the surgery.

Prof. Dr. Ömür Günaldı notes that with modern surgical techniques this step is performed safely and cosmetically, and the scar is usually hidden within the hairline.

Visualization of the Tumor

After opening the brain membrane (dura), the tumor area is visualized under a surgical microscope.
Neuronavigation systems provide a three-dimensional view of the tumor during the operation.

In some centers, intraoperative MRI may also be used to evaluate how much of the tumor has been removed during surgery.

Tumor Removal

The tumor is carefully removed using specialized surgical instruments under a microscope.
When the tumor is located near functional brain areas, electrophysiological monitoring is used during the procedure to prevent damage to speech or movement centers.

Prof. Dr. Ömür Günaldı explains that during surgery the surgeon constantly observes the tumor’s color, texture, and vascular structure to achieve the maximum possible removal without harming healthy brain tissue.

Bleeding Control and Closure

After the tumor is removed, bleeding is controlled, the dura is sutured, and the skull bone is placed back in its original position.
The scalp is closed carefully, and in most cases the surgical scar remains hidden within the hair.

Postoperative Process

After surgery, the patient is closely monitored in the intensive care unit. Medications are given to reduce the risk of brain edema (swelling).
Typically, the patient is transferred to a regular hospital room within one or two days.

Prof. Dr. Ömür Günaldı explains that mild symptoms such as headache, fatigue, or nausea may occur after surgery, but speech, vision, or movement problems must be carefully evaluated.

Recovery Process

Frequent MRI scans are performed during the early postoperative period.
Neurological examinations monitor the patient’s functional status.
Patients are usually discharged within 5–7 days.

Depending on the tumor type and grade, additional treatments such as radiotherapy or chemotherapy may be planned.

Possible Risks and Complications

As with any brain surgery, glial tumor operations may involve certain risks. However, Prof. Dr. Ömür Günaldı emphasizes that modern surgical techniques have significantly reduced these risks compared to the past.

Possible complications include:

• Temporary speech or memory problems
• Muscle weakness or coordination issues
• Bleeding or brain swelling
• Risk of infection (rare)

In most cases, these complications are temporary and can be managed effectively with early intervention.

Postoperative Rehabilitation

After surgery, patients may receive physiotherapy, speech therapy, and psychological support.
This rehabilitation process helps strengthen brain functions and supports recovery.

Prof. Dr. Ömür Günaldı highlights that postoperative rehabilitation is an essential continuation of treatment and significantly improves quality of life, particularly in patients with speech or balance difficulties.

Follow-Up and Monitoring

Glial tumors may have a risk of recurrence. For this reason, Prof. Dr. Ömür Günaldı recommends regular MRI follow-up:

First year: MRI every 3 months
Following years: Check-ups every 6 months

These follow-ups help detect any recurrence of the tumor at an early stage.

Life After Glial Tumor Surgery

Many patients are able to return to their normal lives after surgery.
In low-grade gliomas, complete recovery is often possible.
In high-grade gliomas, surgery combined with radiotherapy and chemotherapy helps increase both life expectancy and quality of life.

Prof. Dr. Ömür Günaldı also emphasizes that maintaining healthy lifestyle habits after surgery supports treatment success. These include:

• Balanced nutrition
• Regular exercise
• Stress management
• Healthy sleep patterns

Glial tumor surgery is a complex procedure that requires advanced technology and surgical expertise. The goal is to remove the tumor as completely as possible while preserving brain functions.

Early diagnosis, accurate surgical planning, and careful postoperative follow-up are the key factors determining treatment success.

As a specialist in neurosurgery, Prof. Dr. Ömür Günaldı emphasizes that glial tumor surgery is not only a technical operation but also a process aimed at restoring and improving the patient’s quality of life.