Long-term surgical oncological and functional outcome of large petroclival and cerebellopontine angle epidermoid cysts: a multicenter study

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 abo...

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Veröffentlicht in:Neurosurgical review 2022-06, Vol.45 (3), p.2119-2131
Hauptverfasser: 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
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Sprache:eng
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Zusammenfassung: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.
ISSN:1437-2320
0344-5607
1437-2320
DOI:10.1007/s10143-021-01702-2