Surgery of intracranial epidermoid cyst cholesteatoma An expirience
- Slides: 10
Surgery of intracranial epidermoid cyst (cholesteatoma): An expirience of 15 cases *Author : dr Milenko Stanić Coauthor : dr R. Vujović , dr M. Spaić , dr R. Benović , dr M. Marković , Dr M. Samardžić , dr I. Popović Institution: Department of Neurosurgery, Clinical center Zemun, Belgrade, Serbia
Introduction • Intracranial epidermoid cyst are benign lesions representing 1% of all intracranial tumors , developed from ectodermal inclusion. • These cysts are potentially curable that are sometimes assosiated with perioperative complications and tend to recur if not completely removed.
Aim • To report our experience in surgery of intracranial epidermoid cyst regarding the localization of the tumor, surgical managment strategy with completeness of excision, duration of symptoms and postoperative complication.
Materials and Methods • This study retrospectively evaluated on 15 cases of intracranial epidermoid cyst treated between January 2000 to June 2013 at the Department of Neurosurgery Clinical center Zemun • follow-up was at least six months
Materials and Methods Analysis patient according to: Ø Ø Ø Sex & age Localisation Degree of resection Duration of symptoms Postoperative complication
Results • There were nine male and six female in the series. The average was 42, 6 years. • Common clinical presentations included : headache, cerebellar dysfunction, cranial nerve impairment, and seizures. • The duration of the disease at admission varied between fifth months to four years.
Results • Nine (60%) patients were infartentorial , fifth patients were (33, 3%) supratentorial and one patient was supra and infratentorial localization. Patient distribution according localisation CPA 6 ili 40% fourth ventricle 3 ili 20% parasellar 3 ili 20% diploice 2 ili 13, 33% CPA & parasellar 1 ili 6, 7%
Results • The resection was total in seven (46, 6%) cases and subtotal in eight (53, 4%) of cases. • Post-operative aseptic/chemical meningitis developed four patients (26. 7%) and deterioration of neurological deficit three (20%) patients. • Mortality rate was 6, 67%.
Case No Age/Sex Lesion localisation Duration of symptoms Degree of resection Postoperative complication 1. J. N. 48/male CPA 2 years incomplete none 2. Z. B. 52/female parasellar 16 months incomplete aseptic meningitis 3. P. M. 63/male diploice 1 year complete none 4. J. M. 25/female diploice 5 years complete none 5. N. S. 51/male CPA 9 months incomplete VII et VIII cranial lesion 6. M. R. 62/male CPA¶sellar 2 years incomplete aseptic meningitis 7. Lj. Z. 46/female fourth venricle 5 months complete none 8. Z. G. 29/male parasellar 16 months complete hemiparesis 9. M. J. 52/ female CPA 3 years incomplete aseptic meningitis 10. Z. Ž. 61/female fourth ventricle 6 months complete none 11. V. R. 45/male CPA 16 months incomplete VII et VIII cranial lesion 12. N. K. 57/female fourth ventricle 8 months complete none 13. Z. M. 39/male CPA 12 months incomplete aseptic meningitis 14. R. Z. 36/male parasellar 2 years complete none 15. G. Z. 48/male CPA 20 months incomplete none
Conclusion • Epidermoid cysts are characterized by a long evolution. • The diagnosis is relatively characteristic in the imagery • Prognosis was favorable with a complete surgical resection.
