Craneotomía vigil en tumores cerebrales: rol del fonoaudiólogo, dentro del equipo multidisciplinario, en la preservación funcional del lenguaje

Abstract

The use of procedures such as direct electrical stimulation (DES) for brain mapping of eloquent functions has become the gold standard in awake craniotomy, optimizing brain tumor resection and preserving critical functions like language. Furthermore, three stages must be considered in which cognitive-linguistic performance is periodically assessed: preoperative, intraoperative, and postoperative. Traditionally, the intraoperative stage is based on tasks of varying complexity and approaches focused on anatomical localization. However, advances in neuroscience have demonstrated that language is organized in dynamic and distributed networks, requiring more sensitive, specific, and ecologically valid assessments. In this context, the speech-language pathologist plays a crucial role in all phases of the process. Therefore, this paper presents a critical reflection based on a narrative review of the available literature and clinical experience. The role of the speech-language pathologist in awake craniotomy is described and explained, highlighting their contribution to task planning, real-time functional monitoring, and language rehabilitation. Likewise, the need arises to establish interdisciplinary committees starting in the preoperative phase to optimize clinical decision-making and the incorporation of technological tools adaptable to the surgical environment, thereby promoting better functional communication outcomes.