Neurosurgical Management of Intracranial Epidermoid

Authors

  • SHEIKH MUHAMMAD AFZAL Department of Neurosurgery, Sheikh Zayed Hospital Rahim Yar Khan
  • MUHAMMAD ANWAR PGMI / Lahore General Hospital, Lahore
  • MUHAMMAD IBRAHIM KHAN Department of Neurosurgery, Sheikh Zayed Hospital, Rahim Yar Khan
  • Naseer Ahmad Ch Department of Neurosurgery, Sheikh Zayed Hospital, Rahim Yar Khan
  • Khalid Mahmood Department of Neurosurgery, Sheikh Zayed Hospital, Rahim Yar Khan

Keywords:

Epidermoid, cerebellopontine angle, trigeminal neuralgia, Pineal region.

Abstract

Objective: Epidermoid cyst or cholesteatoma is a congenital slow growing lesion. The objective was to analyze clinical presentation surgery and outcome after surgery.
Study Design: Retrospective observational study.
Materials and Methods: This study represents a retrospective review of patients treated with epidermoid cyst, during a period of 18 years between 1995 to 2012. It was conducted at the department of Neurosurgery Sheikh Zayed Hospital, Rahim Yar Khan and department of Neurosurgery PGMI / LGH Lahore and department of Neurosurgery AMDC Farooq Hospital, Lahore.
Results: The age of our patients ranged from 18 to 40 years, with male predominance. The predominating symptoms were related to the 5th, 7th and 8th cranial nerve and headache. Our study included 10 cases of epidermoid cysts; four of them were in CPA area, two suprasellar region and one was at pineal region. It was not always possible to determine if the signs and symptoms were due to local involvement by the epidermoids, increased intracranial pressure or both. The age of our patients ranged from 18 to 40 years, with male predominance. The retrosigmoid approach was used in 5 patients, ® Frontal craniotomy in 2 cases, Rt interhemispheric transtentorial approach in one patient and sub-temporal approach in one case. Parental portaline approach in 1 case. Total resection of epidermoid cyst was accomplished in 7 cases. To minimize recurrence, the residual epidermoid was carefully coagulated with the aid of microscope and bipolar diathermy without damaging surrounding neurovascular structures.
Conclusion: Surgical management of intracranial dermoid has encouraging and good results. Use of endoscope is good adjunct for complete removal of epidermoid from angles and corners of the lesion.

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2014-06-30

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