title: Whole Course Neuroendoscopic Resection of Cerebellopontine Angle Epidermoid Cysts.
abstract: Background Epidermoid cysts are the third most common tumor of the cerebellopontine angle (CPA). Diagnosis often occurs after involvement of the sulci and cisterns that surround nerves and blood vessels, making complete resection highly challenging. Objective To determine the efficacy of whole course neuroendoscopic surgery in the management of CPA epidermoid cysts. Methods We performed a retrospective analysis of clinical data of 13 male and 17 female patients (mean age: 42.4 ± 11.4 years) who presented with a CPA epidermoid cyst and underwent whole course neuroendoscopy. Complications and tumor recurrence were assessed at follow-up. Results Clinical manifestations included an initial symptom of headache (n = 21), gait instability (n = 6), intracranial hypertension (n = 13), posterior cranial nerve symptoms (n = 6), ataxia (n = 5), and hydrocephalus (n = 1). All patients tolerated tumor resection with subsequent symptomatic improvement, and the results of the postoperative magnetic resonance imaging scan did not show any remnants of tumor. Mean duration of surgery was 2.61 ± 0.47 hours, mean loss of blood was 96.8 ± 35.4 mL, and the mean duration of hospitalization was 7.5 ± 2.25 days. Postoperative complications (8 of 30 [26.7%]) included fever (n = 5), communicating hydrocephalus (n = 1), facial nerve paralysis (n = 1), and abducens nerve palsy (n = 1). Tumor recurrence was observed in two patients (6.7%). No deaths or intracranial hemorrhage was reported. Conclusions The characteristics of epidermoid cysts make them amenable to whole course neuroendoscopic resection. Use of physiologic/pathologic interspaces and neuroendoscopic angulations decreases traction on the brain, improves complete resection rates, and decreases postoperative complications.
authors: Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Peking University Ninth School of Clinical Medicine, Capital Medical University School of Oncology, Beijing, China.
authors: Zhiqiang
authors: Z
authors: Hu
authors: Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Peking University Ninth School of Clinical Medicine, Capital Medical University School of Oncology, Beijing, China.
authors: Feng
authors: F
authors: Guan
authors: Department of Neurosurgery, Qiqihaer The 1st Hospital, Qiqihaer, China.
authors: Tiejiang
authors: T
authors: Kang
authors: Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Peking University Ninth School of Clinical Medicine, Capital Medical University School of Oncology, Beijing, China.
authors: Hui
authors: H
authors: Huang
authors: Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Peking University Ninth School of Clinical Medicine, Capital Medical University School of Oncology, Beijing, China.
authors: Bin
authors: B
authors: Dai
authors: Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Peking University Ninth School of Clinical Medicine, Capital Medical University School of Oncology, Beijing, China.
authors: Guangtong
authors: G
authors: Zhu
authors: Department of Neurosurgery, Beijing Shijitan Hospital, Capital Medical University, Peking University Ninth School of Clinical Medicine, Capital Medical University School of Oncology, Beijing, China.
authors: Beibei
authors: B
authors: Mao
authors: Department of Oncology, Beijing Shijitan Hospital, Capital Medical University, Peking University Ninth School of Clinical Medicine, Capital Medical University School of Oncology, Beijing, China.
authors: Zhuang
authors: Z
authors: Kang
mesh_terms: D000328:Adult; D002526:Cerebellar Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002530:Cerebellopontine Angle / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D004814:Epidermal Cyst / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome