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Cerebellopontine Angle Epidermoid : A Clinical Study

Sanjeev Attry , Amit kumar Mukherjee1 , Mahesh Chaudhari2 , Sanjeev Attry3 , Pavan Kumar Tungala4

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International Journal of Neurology and Neurosurgery 12(2):p 105-113, April-June 2020. | DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.12220.7

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Amit kumar Mukherjee, Mahesh Chaudhari, Sanjeev Attry et al. Cerebellopontine Angle Epidermoid : A Clinical Study. Int J Neurol Neurosurg. 2020;12(2):105–113.
 

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Abstract

Objective : Aim of this study is to correlate final outcome with the extent of surgical removal of cerebellopontine angle epidermoid, in term total or near total resection, recurrence and morbidity. Being a benign nature,
neurosurgically shown a great concern because of close proximity and adherence to the cranial nerves, intracranial vessels and brain stem. Methods: We use our data from 21 consecutive patients of cerebellopontine epidermoid that were surgically treated in our institute from 1995-2012 were reviewed and the final outcome were assessed with emphasis on outcome after surgery, long term follow up results and anatomic relationship between the tumor and surrounding neurovascular structures. Results: The average age of patients were 33.14 years at onset of symptom and 36.33 years at the time of operation. The mean duration from onset of symptoms to surgery was 3.1 years. Of 21, 12 were female and 9 were male. Headache was present in 9 patients most common presentation followed by hearing impairmentin 7 patients. Most of them confined to cerebellopontine angle, hypodense non-enhancing lesion in 8 patients, 3 have supratentorial extension. Retromastoid approach in 14 and supine in 12 patients rest all in sitting position. Total removal done in 16 patients. After total removal transient cranial nerve palsy in 9 patients which were improved in 7 patients. Cerebrospinal fluid leak in 2 patients improved by repeated lumber puncture. Pulmonary embolism in1 patient. 18 were followed over mean period of 60 month, range from 1-11 years. 3 had recurrence ,two in near total excision, one in sub-total excision and 2 had persistent cranial nerve paresis. Conclusion : -Approach needed to be conservative in whom capsule is adherent to brain stem and neurovascular structures. Aggressive removal had transient but significant short term cranial nerve and brain stem dysfunction.
Total removal of cerebellopontine angle epidermoids does not result in significantly increased long term morbidity and mortality and should be the goal of surgical treatment .

Keywords: Epidermoid Tumor ; Cerebellopontine and Reteromastoid Approach.
 

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Cite this article

Amit kumar Mukherjee, Mahesh Chaudhari, Sanjeev Attry et al. Cerebellopontine Angle Epidermoid : A Clinical Study. Int J Neurol Neurosurg. 2020;12(2):105–113.
 

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DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.12220.7

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