Commentary: Fully Endoscopic Resection of an Epidermoid Cyst of the Cerebellopontine Angle: Bilateral Resection via a Unilateral Approach

2021 ◽  
Author(s):  
Nasr Hussain ◽  
Rashid Jooma
2020 ◽  
Author(s):  
Sricharan Gopakumar ◽  
Visish M Srinivasan ◽  
Himanshu Sharma ◽  
Jacob Cherian ◽  
Akash J Patel

ABSTRACT BACKGROUND AND IMPORTANCE Epidermoid cysts are rare, benign intracranial neoplasms that typically arise at the cerebellopontine angle (CPA) and can be extensive lesions that intricately involve many critical neurovascular structures. We describe the case of a patient who presents with the classic picture of CPA epidermoid cyst and describe the value of the 4K endoscope for resection, which is illustrated in our accompanying surgical video. CLINICAL PRESENTATION The patient presents with headache, nausea, and vomiting accompanied by dizziness and balance issues. Radiographic imaging demonstrated a large lesion highly consistent with epidermoid cyst which involved the left CPA, encircled the basilar artery, and extended to the opposite side. Surgery was planned with a small left-sided retrosigmoid craniotomy with use of a 2-dimensional 4K endoscope to aid in resection, particularly of the contralateral side. This approach was successful with gross total resection apparent at 14-mo follow-up. CONCLUSION We describe the use of a fully endoscopic technique from a unilateral approach for resection of a lesion that extended in the CPA bilaterally. Additionally, we highlight the relevant neuroanatomical and neurovascular structures in this highly critical intracranial region which is well-visualized through endoscopy in the associated surgical video.


2020 ◽  
Vol 144 ◽  
pp. 238-243
Author(s):  
Tomoki Kaneko ◽  
Yasunari Fujinaga ◽  
Fumihito Ichinohe ◽  
Toshihiro Ogiwara ◽  
Tetsuyoshi Horiuchi

Author(s):  
Eduardo de Arnaldo Silva Vellutini ◽  
Felix Hendrik Pahl ◽  
Aldo Eden Cassol Stamm ◽  
Marcos de Queiroz Teles Gomes ◽  
Matheus Fernandes de Oliveira ◽  
...  

2018 ◽  
Vol 16 (6) ◽  
pp. E172-E173
Author(s):  
Ken Matsushima ◽  
Michihiro Kohno ◽  
Nobuyuki Nakajima ◽  
Norio Ichimasu

Abstract The combined transpetrosal approach enables wide exposure around the petroclival region by cutting the tentorium and superior petrosal sinus. We often choose this approach for removal of tumors ventral to the facial and vestibulocochlear nerves, such as petroclival meningioma and epidermoid cyst, because complete removal of the tumor under direct visualization is required to prevent its later recurrence, especially in young patients. Recent reports revealed anatomical variations of the drainage of the superior petrosal sinus, and dural incision considering preservation of the superior petrosal vein was proposed.1-3 This 3-dimensional video shows a patient with an epidermoid cyst, which was surgically treated using the combined transpetrosal approach, with consideration of the variation of the superior petrosal sinus and preservation of the drainage route of the superior petrosal vein. The video was reproduced after informed consent of the patient. The patient is a 31-yr-old woman who presented with a left cerebellopontine angle epidermoid cyst extending into Meckel's cave. The superior petrosal sinus was of the lateral type, draining only laterally into the transverse–sigmoid junction without medial connection with the cavernous sinus.1 The combined transpetrosal approach was performed with cutting of the superior petrosal sinus medial to the entry point of the superior petrosal vein, in order to preserve its drainage into the transverse–sigmoid junction. Meckel’ cave was opened along its lateral margin, and tumor removal was accomplished, leaving only a minute part of the capsule strongly adhering to the neurovascular structures. The patient had no new permanent neurological deficits during follow-up. The figures in the video were modified from Matsushima et al1 by permission of the Congress of Neurological Surgeons.


2006 ◽  
Vol 13 (6) ◽  
pp. 669-672 ◽  
Author(s):  
Fan-gang Meng ◽  
Cheng-yuan Wu ◽  
Zhao-hua Liu ◽  
Shu-gan Zhu ◽  
Yu-guang Liu

2019 ◽  
Vol 38 (03) ◽  
pp. 210-214
Author(s):  
Eduardo Cambruzzi ◽  
Nelson Pires Ferreira ◽  
Gabriel Barcellos ◽  
Pablo Fruet

AbstractEpidermoid cysts (ECs) of the central nervous system (CNS) constitute benign circumscribed lesions that are more common in lateral than in midline sites. Epidermoid cysts of the CNS arise more frequently in the cerebellopontine angle, around the pons, near the sella, within the temporal lobe, in the diploe, and in the spinal canal. Most common tumoral lesion of sellar region is pituitary adenoma, and sellar cystic epithelial masses may be difficult to differentiate based only on clinical and imaging findings. Epidermoid cysts are covered by keratinized squamous epithelium and are usually filled with keratin lamellae. The process is, for the most part, maldevelopmental in origin, presumably arising from trapped surface ectodermal elements in association with the developing CNS during the closure of the neural groove or formation of the secondary cerebral vesicles. In the present study, the authors describe a case of sellar epidermoid cyst producing endocrine alterations and visual disturbance in a 35 years woman, and review the physiopathological and diagnostic criteria of this lesion.


2015 ◽  
Vol 77 (01) ◽  
pp. 011-018
Author(s):  
Kenneth D'Andrea ◽  
Emily Stucken ◽  
Seilish Babu ◽  
Michael LaRouere ◽  
Daniel Pieper ◽  
...  

2017 ◽  
Vol 16 (04) ◽  
pp. 232-235
Author(s):  
Pramod Giri ◽  
Kirti Jaiswal ◽  
Milind Bhatkule ◽  
Vaibhav Chavan

AbstractAn epidermoid cyst is a rare intracranial neoplasm. It is mostly found in cerebellopontine angle, suprasellar region, interhemispheric fissure, and is rarely found in other locations too. Epidermoid cyst at the parietooccipital area is rare, and calcification among epidermoids is very unusual and dystrophic in nature. The clinical presentation is usually in adults because of slow-growing nature of epidermoid cyst. Here, we present the case of a 5-year-old child with intellectual disability who presented with seizure and frequent crying episodes and was diagnosed with an intradural extra-axial calcified mass of size 8 × 5.5 × 5 cm in the right parietooccipital region which turned out to be a calcified epidermoid cyst and was excised successfully in toto. This is the youngest reported case of the calcified epidermoid cyst at an unusual site of our knowledge.


2021 ◽  
Vol 5 (2) ◽  
pp. V2
Author(s):  
Sebastián J. M. Giovannini ◽  
Guido Caffaratti ◽  
Tomas Ries Centeno ◽  
Mauro Ruella ◽  
Facundo Villamil ◽  
...  

Surgical management of vestibular schwannomas has improved over the last 30 years. Whereas in the past the primary goal was to preserve the patient’s life, today neurological function safeguarding is the main objective, with numerous strategies involving single resection, staged resections, postoperative radiosurgery, or single radiosurgery. The retrosigmoid approach remains the primary pathway for surgical access to the cerebellopontine angle (CPA). The use of an endoscope has great advantages. It contributes to the visualization and resection of residual tumor and also reduces the need for cerebellar retraction. The authors present a fully endoscopic resection of a large-sized vestibular schwannoma with facial nerve preservation. The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID21106


Author(s):  
Fabio Di Giustino ◽  
Rudi Pecci ◽  
Beatrice Giannoni ◽  
Paolo Vannucchi

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