[Surgical Strategy for Cerebellopontine Angle Epidermoid Cysts].

Abstract

Intracranial epidermoid cysts are congenital benign tumors; however, there is a long-term risk of recurrence if the tumor capsule is left behind perioperatively. Additionally, in cerebellopontine angle surgery, in which cranial nerves and blood vessels are densely concentrated, cranial nerve functions must be preserved besides radical removal of the tumor capsule. Particularly, the optimal surgical field should be obtained under direct visualization to avoid cranial nerve damage due to manipulation over cranial nerves and leaving the tumor behind in the blind spot of the surgical field. Therefore, besides the use of intraoperative monitoring, high surgical skills are required to use four skull base surgical approaches, such as lateral suboccipital retrosigmoid approach (LSO), anterior transpetrosal approach (ATP), combined transpetrosal approach, and ATP and LSO, depending on the size and progression of the tumor. Moreover, this disease should be treated at a specialized facility for skull base surgery.