Surgery of Cerebellopontine Angle Epidermoid Cysts: Role of the Widened Retrolabyrinthine Approach Combined with Endoscopy

Abstract

RLA combined with endoscopy should be considered as the standard approach for excision of epidermoid cysts. Extension of this approach into a TLA or transcochlear approach will depend on preoperative difficulties and preoperative hearing.

Endoscope‐assisted frenotomy approach to median upper neck masses: Clinical outcomes and safety (from a phase II clinical trial)

“…These masses are described as pearly tumors because of the shiny, smooth, and waxy characteristics of their dry keratin. They can range in size from a few millimeters to 12 cm . The majority of the masses are dermoid or epidermoid cysts …”

“…The most common presentation of a median upper neck mass is one that is painless and slow-growing over the course of many years because of accumulation of cutaneous products. 8 Typically, the mass is soft, mobile, and unattached to overlying skin. These masses are described as pearly tumors because of the shiny, smooth, and waxy characteristics of their dry keratin.…”

“…They can range in size from a few millimeters to 12 cm. 8 The majority of the masses are dermoid or epidermoid cysts. 9 Anatomically, it is possible to distinguish 3 different types of masses: median genioglossal, median geniohyoid, and median digastric, according to the anatomic relationship between the mass and the muscles of the floor of the mouth, specifically, the genioglossus, geniohyoid, mylohyoid, and digastric muscles.…”

Giant intracranial epidermoids: is total removal feasible?

“…40,44 In such cases, surgeons have resorted to subtotal resection or a staged operation through 2 different approaches: the use of an endoscope to visualize beyond the restrictive limits of the traditional approach or the use of a combined infra-and supratentorial approach. 15,44,48 Altschuler and colleagues 4 found that patients who required multiple procedures resulting in fixed deficits had an extensive lesion and incomplete initial resection, which they believed to be attributable to a limited initial exposure. They contemplated whether the use of a more extensive approach in a first operation would have resulted in better tumor resection, improved outcome, and reduced recurrence.…”

Ruptured pediatric cerebellopontine angle epidermoid cyst: a case report detailing radiographic evolution and clinical course

“…Deficits of CNs V-VII and X tend to be transient and typically resolve over 0.5-1.5 years, but damage to CN VIII with hearing loss often persists. 7,14 Less common complications include CSF leakage (4%-8%), symptomatic hydrocephalus (14%), vestibular or cerebellar dysfunction, and pseudomeningocele (5%). 2,3,14,15,21 conclusions Following CPA EC rupture causing pericystic brainstem edema, our patient experienced resolution of her presenting symptoms following subtotal resection without postoperative neurological deficits or complications.…”