Importance of appropriate surgical approach selection for radical resection of cerebellopontine angle epidermoid cysts with preservation of cranial nerve functions: our experience of 54 cases

Sakamoto, Hiroki; Kohno, Michihiro; Matsushima, Ken; Ichimasu, Norio; Nakajima, Nobuyuki; Yoshino, Masanori

doi:10.1007/s00701-021-04840-0

Cited by 7 publications

(7 citation statements)

References 40 publications

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“…The radical surgery resulted in neurological deficits found to be minimum in the non-radical group [7]. Thus, limited surgery in partial excision should be considered if symptoms are not controlled on medications to avoid permanent complications.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Cerebellopontine Angle (CPA) Lipoma Presenting As Trigeminal Neuralgia: A Case Report

Dudulwar¹,

Agrawal²,

Kabra³

2022

Cureus

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The report details an instance of a 35-year-old male, who came to our hospital with a two-year history of typical trigeminal neuralgia on the left side, predominantly in V2 and V3 dermatomes. The patient was started on medications, but pain could not be controlled by increasing doses and adjuvant medications over the last three months. A lesion was seen on the MRI in the left cerebellopontine angle (CPA) region, hyperintense on T1W and decreased on fat-suppressed imaging, characteristic of lipoma. Being an intractable case, surgery was offered to the patient. Following this, a left retromastoid suboccipital craniectomy was done, and lipoma was excised, decompressing the trigeminal nerve and relieving neuralgia symptoms. In the post-op period, the patient was completely pain-free, but he developed left-sided hearing loss and left facial palsy, Brackmann grade 4, which improved to Brackmann grade 3 on the three-month follow-up.

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Section: Discussionmentioning

confidence: 99%

Surgical Management of Cerebellopontine Angle (CPA) Lipoma Presenting As Trigeminal Neuralgia: A Case Report

Dudulwar¹,

Agrawal²,

Kabra³

2022

Cureus

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“…Postoperative cranial nerve complications can signi cantly reduce the quality of life of patients and should be avoided. Intraoperative neuroelectrophysiological monitoring can reduce postoperative cranial nerve (CN) complications and improve postoperative CN preservation rate [4].…”

Section: Discussionmentioning

confidence: 99%

“…In our study, 22 cases involving epidermoid cysts in the CPA were treated by the retrosigmoid approach using a neuroendoscope. Large epidermoid cysts in the CPA can usually be removed by the endoscopic retrosigmoid approach [4]. Using the retrosigmoid approach, it is not di cult to remove an ipsilateral CPA cyst; although it can be di cult to expose cysts in the prepontine cisterna.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have also reported that the total resection of a cyst can signi cantly reduce its recurrence without increasing morbidity and mortality; this should be considered the goal of surgical treatment [5; 23]. In a previous study of epidermoid cysts in the CPA, Sakamoto et al found that if the cyst envelope was not completely removed, the recurrence rate was high and radiotherapy was ineffective [4]. Furthermore, these authors noted that resection was more di cult in the second operation than in the rst operation.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, these authors noted that resection was more di cult in the second operation than in the rst operation. Therefore, these authors reported that it is important to attempt a safe and more aggressive capsule resection in the initial surgery of CPA epidermoid cysts [4]. Hasegawa et al reported that recurrent cases tend to lead to a greater extent of subtotal resection due to stronger adhesions; therefore, surgeons should take all possible measures to achieve the maximum degree of safe resection during the rst surgery [24].…”

Section: Discussionmentioning

confidence: 99%

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Strategy and Efficacy of Whole-Course Neuroendoscopic Surgery for Epidermoid Cysts in the Base of the Skull

Liu

Zheng

Shao

et al. 2022

Preprint

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Objective: To discuss the strategy and efficacy of neuroendoscopic surgery for the treatment of epidermoid cysts in the base of the skull. Methods: This study retrospectively analyzed the clinical data of 28 patients with epidermoid cysts in the base of their skulls and treated by neuroendoscopic surgery in the Department of Neurosurgery at The First Affiliated Hospital of Bengbu Medical College from January 2015 to April 2022. Of the 28 cases, 22 cases received surgery through the retrosigmoid sinus approach, two cases received surgery through the nasal sphenoidal approach and four cases received surgery through the anterior infratemporal rock approach. Postoperative follow-up was performed to determine the operative effect and record complications. Result: Of the 28 patients, 15 were male and 13 were female; age ranged from 31 to 67 years (mean, 46±7 years). Headache and dizziness were the most common symptoms. Gross-total/near-total resection was performed in 27 cases (96.4%) and subtotal resection in one case (3.6%). The preoperative symptoms of all patients were relieved to varying degrees. With regards to postoperative conditions of the 28 patients; intracranial infection occurred in two patients (7.1%), aseptic meningitis in four patients (14.3%), still right abducens nerve palsy in one patient (3.6%) and acute obstructive hydrocephalus in one patient (3.6%); cerebrospinal fluid rhinorrhea was not observed in any of the patients. During follow-up, one patient (3.6%) developed residual cyst enlargement and one patient (3.6%) developed obstructive hydrocephalus. Conclusion: Neuroendoscopic surgery can significantly improve the resection rate of epidermoid cysts in the base of the skull, reduce trauma and traction on important structures, reduce postoperative complications, shorten the length of hospital stay, and is a safe and effective procedure.

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Fully neuroendoscopic resection of cerebellopontine angle tumors through a retrosigmoid approach: a retrospective single-center study

Zhang,

Wang,

Liu

et al. 2023

Neurosurg Rev

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Importance of appropriate surgical approach selection for radical resection of cerebellopontine angle epidermoid cysts with preservation of cranial nerve functions: our experience of 54 cases

Cited by 7 publications

References 40 publications

Surgical Management of Cerebellopontine Angle (CPA) Lipoma Presenting As Trigeminal Neuralgia: A Case Report

Surgical Management of Cerebellopontine Angle (CPA) Lipoma Presenting As Trigeminal Neuralgia: A Case Report

Strategy and Efficacy of Whole-Course Neuroendoscopic Surgery for Epidermoid Cysts in the Base of the Skull

Fully neuroendoscopic resection of cerebellopontine angle tumors through a retrosigmoid approach: a retrospective single-center study

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