Chittur Viswanathan Gopalakrishnan1, Khursheed A Ansari2, Suresh Nair3, Girish Menon4. 1. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala 695011, India. Electronic address: doc_gopal@yahoo.com. 2. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala 695011, India. Electronic address: drkhursheed@rediffmail.com. 3. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala 695011, India. Electronic address: snair@sctimst.ac.in. 4. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala 695011, India. Electronic address: neuron1967@gmail.com.
Abstract
OBJECTIVES: To study posterior fossa epidermoids treated surgically at our institute and to compare their long term outcome with respect to extent of surgical decompression. MATERIALS AND METHODS: Retrospective analysis of 50 cases of posterior fossa epidermoid surgically treated at our institute between 1997 and 2007. RESULTS: The mean duration from onset of symptoms to surgery was 2.5 years. Patients with cerebellopontine angle (CPA) epidermoids presented predominantly with trigeminal neuralgia (35%) and hearing loss (29%) while patients with fourth ventricle epidermoids had features of raised intracranial pressure (ICP) and gait ataxia (69.2% each). The rate of recurrence was 9% in tumors considered totally removed and 93% in those subtotally removed. Of the 17 patients with recurrences, 3 (7.9%) underwent a second operation. The mean duration of follow up at first recurrence was 9.3 years. CONCLUSION: Based on our experience, the rate of recurrence is significantly higher after subtotal removal as compared to total removal of epidermoids on long-term follow up. Symptomatic recurrence requiring re-exploration is evident only after a long duration (∼10.9 year) following primary surgery. Hence, total removal without producing new neurological deficits should be the standard goal when operating on posterior fossa epidermoid cysts.
OBJECTIVES: To study posterior fossa epidermoids treated surgically at our institute and to compare their long term outcome with respect to extent of surgical decompression. MATERIALS AND METHODS: Retrospective analysis of 50 cases of posterior fossa epidermoid surgically treated at our institute between 1997 and 2007. RESULTS: The mean duration from onset of symptoms to surgery was 2.5 years. Patients with cerebellopontine angle (CPA) epidermoids presented predominantly with trigeminal neuralgia (35%) and hearing loss (29%) while patients with fourth ventricle epidermoids had features of raised intracranial pressure (ICP) and gait ataxia (69.2% each). The rate of recurrence was 9% in tumors considered totally removed and 93% in those subtotally removed. Of the 17 patients with recurrences, 3 (7.9%) underwent a second operation. The mean duration of follow up at first recurrence was 9.3 years. CONCLUSION: Based on our experience, the rate of recurrence is significantly higher after subtotal removal as compared to total removal of epidermoids on long-term follow up. Symptomatic recurrence requiring re-exploration is evident only after a long duration (∼10.9 year) following primary surgery. Hence, total removal without producing new neurological deficits should be the standard goal when operating on posterior fossa epidermoid cysts.
Authors: Kurt Grahnke; Daniel Burkett; Daphne Li; Caroline Szujewski; John P Leonetti; Douglas E Anderson Journal: J Neurol Surg B Skull Base Date: 2018-01-09
Authors: Hyeong-Cheol Oh; Chang-Ki Hong; Jihwan Yoo; Kyu-Sung Lee; Yoon Jin Cha; Sung Jun Ahn; Sang Hyun Suh; Hun Ho Park Journal: Neurosurg Rev Date: 2021-09-28 Impact factor: 3.042