Neurosurgery Management Of Cerebellopontine Epidermoid Cysts: A Study Of 7 Cases

Object To analyse the clinical characteristics of cerebellopontine epidermoid cysts,search for the appropriate microinvasive surgery methods, and improve the diagnosis and treatment of cerebellopontine epidermoid cysts.Methods Seven patients having epidermoids in the cerebropontine angle weresurgically treated in our department during a 6-year period (1999 up to 2005). These cases were retrospectively analyzed. The average duration of follow-up was 3.5 years.Results The age at the time of presentation ranged from 21 to 54 years (mean, 37.8years). There were 6 male and 1 female patients. The average duration of complaints was 5 months. Headache and cranial nerves ( most commonly V and VIII nerve) , were the commonest symptoms. The average tumor size was 4.1 cm. The sub_occipital retrosigmoid approach is used to excise the epidermoids in all patients, respectively. Total excision of the solid part of the tumor and the capsule was achieved in 5 patients. In 1 case, the solid part of the tumor was completely resected, but at least, a part of the tumor capsule was left behind. In 1 case, a part of the solid portion of the tumor was either deliberately or inadvertently left behind. Incomplete tumor resection was primarily due to adhesions of the capsule to brain stem and basal artery in the region. Multiple cranial nerve deficits were seen preoperatively, andfacial weakness was the most common new deficit postoperatively. During the period of follow_up, all patients are leading active lives.Conclusion By achieving excellent exposure and using meticulous microsurgicaltechnique, it is possible to resect all or radically epidermoid tumor in cerebellopontine angle via suboccipital retrosigmoid approach with minimal new cranial nerve deficits.