Anterior tentorium-based epidermoid tumours: results of radical surgical treatment in 96 cases.

A retrospective analysis of 96 surgically treated tentorium and anterior tentorial hiatus-based epidermoid tumours from 1997 - 2004 is presented. The most prominent symptoms were headache (53.1%) and ataxia (44.8%). The average tumour size was 4.4 cm. Surgical approaches included posterior cranial fossa route (85 cases), basal subtemporal middle fossa route (9 cases) and combined posterior fossa and subtemporal routes in two cases. Total tumour resection was performed in 46 patients. Eight and four patients developed transient and sustained postoperative neurological deficits respectively. There was mortality in two patients. There was non-symptomatic recurrence of the tumour in two cases. Ninety-four patients are leading active functional lives. Radical and safe resection of anterior tentorium-based epidermoid tumours is associated with symptomatic relief and lasting cure. Extensive drilling of the petrous bone can be avoided. Gentle dissection of the tumour and capsule from the critical neurovascular structures can limit post-operative morbidity.