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- Title
Long-term surgical oncological and functional outcome of large petroclival and cerebellopontine angle epidermoid cysts: a multicenter study.
- Authors
Sellier, Aurore; Troude, Lucas; Baumgarten, Clément; Caudron, Yohan; Bretonnier, Maxime; Gallet, Clémentine; Boissonneau, Sébastien; Cungi, Pierre-Julien; Morandi, Xavier; Dufour, Henry; Fournier, Henri-Dominique; Gay, Emmanuel; Kalamarides, Michel; Roche, Pierre-Hugues
- Abstract
Cranial nerve (CN) disorders are the foremost symptoms in cerebellopontine angle (CPA) and petroclival area (PCA) epidermoid cysts (EC).The aim of this work was to assess the long-term surgical results on CN function and tumor control in these patients. We performed a retrospective cohort study about 56 consecutive patients operated on for a CPA or PCA EC between January 2001 and July 2019 in six participating French cranial base referral centers. Sixteen patients (29%) presented a PCA EC and 40 a CPA EC (71%). The median clinical and radiological follow-up was 46 months (range 0–409). Preoperative CN disorders were present in 84% of patients (n = 47), 72% of them experienced CN deficits improvement at the last follow-up consultation (n = 34): 60% of cochlear and vestibular deficits (n = 9/15 in both groups), 67% of trigeminal neuralgia (n = 10/15), 53% of trigeminal hypoesthesia (n = 8/15), 44% of lower cranial nerve disorders (n = 4/9), 38% of facial nerve deficits (n = 5/8) and 43% of oculomotor deficits (n = 3/7) improved or were cured after surgery. New postoperative CN deficits occurred in 48% of patients (n = 27). Most of them resolved at the last follow-up, except for cochlear deficits which improved in only 14% of cases (n = 1/7). Twenty-six patients (46%) showed evidence of tumor progression after a median duration of 63 months (range 7–210). The extent of resection, tumor location, and tumor size was not associated with the occurrence of new postoperative CN deficit or tumor progression. A functional nerve-sparing resection of posterior fossa EC is an effective strategy to optimize the results on preexisting CN deficits and reduce the risk of permanent de novo deficits.
- Subjects
CEREBELLOPONTILE angle; EPIDERMAL cyst; SKULL base; CRANIAL nerves; TRIGEMINAL neuralgia
- Publication
Neurosurgical Review, 2022, Vol 45, Issue 3, p2119
- ISSN
0344-5607
- Publication type
Article
- DOI
10.1007/s10143-021-01702-2