The understanding of the neural basis of speech-language has evolved since the traditional models were described in the nineteenth century. The classical anatomical model of language was first represented in the works of Dr. Paul Pierre Broca [1]. He describes a localizationist theory, where discrete cortical areas of the brain are responsible for speech production, traditionally referencing “Broca’s area”; located on the pars opercularis (pOp) and pars triangularis (pT) of the frontal operculum within the dominant inferior frontal gyrus (IFG) (Table 1). Historically, Broca’s area was associated with speech motor functions and, when damaged, patients present with non-fluent aphasia characterized by severely reduced, effortful speech, and word-finding difficulty. However, there is accumulating evidence that challenges the notion that Broca’s area is critical for speech production [2], [3], [4]. For instance, intracranial EEG examining the temporal properties of activity in response to repeating words showed that Broca’s area activated prior to speech articulation and was silent during active speech articulation, while the ventral pre-motor cortex (vPMC) was actually activated during speech production, suggesting that Broca’s area may be involved mainly in pre-articulatory functions.

Lesions restricted to the traditional cortical Broca’s area, often result in mild and more transient non-fluent aphasia, whereas more severe and permanent speech deficits require lesions to extend posteriorly to the vPMC and deeper to the underlying white matter tracts. The theory of a subcortical “bottleneck” of white matter tracts deep to the cortical Broca’s area, including the frontal aslant tract (FAT), arcuate fasciculus (AF), and lateral bundle of the superior longitudinal fasciculus (SLF3), posits that the full spectrum of severe speech deficits from damage to IFG is likely, in large part, due to damage to multiple eloquent tracts that converge just deep to the Broca area [5]. In fact, a recent re-examination of Broca’s original patients using high-resolution MRI revealed extensive subcortical damage that was not originally appreciated by Dr. Broca [3].

Because of the important language eloquence in the frontal operculum, patients with lesions in or adjacent to Broca’s area were thought to be at higher risk of postoperative language morbidity resulting in the traditional mantra that tumors in this area are often deemed unresectable. In line with the contemporary connectomal description of language networks and the dynamic reorganization of language circuits during disease, we aimed to add up to the literature with our own feasibility study on glioma surgery within the pOp and pT. The overall lack of consensus on the anatomo-functional properties of Broca’s area highlights the need to study the risk profile and feasibility of resecting tumors from this area.