Epidermoid Cyst in the Cerebellopontine Angle: Technical Description Video

Abstract

Objectives To describe the operative technique for treatment of epidermoid cysts in the cerebellopontine angle (CPA). Design The present video is a case report. Setting Patient is positioned in three-quarters prone. Retrosigmoid approach should be made under neurological monitoring and with neuronavegation to help achieve maximal safe resection. The skin incision is vertical, slightly curved, 5 mm medial to the mastoid notch. Craniectomy is superiorly limited by the transverse sinus and laterally limited by the sigmoid sinus. A C -shaped durotomy is made with its base protecting the sigmoid sinus. The lesion is removed in piecemeal fashion ( Fig. 1 ). The neurological monitoring helps. Results The patient was discharged 2 days later without neurological deficits. Conclusions The surgical treatment associated with neurological monitoring and neuronavegation is a safe procedure to treat epidermoid cysts in the CPA. The link to the video can be found at: https://youtu.be/sEuFyq9c2sw .

Keywords: cerebellopontine angle lesion; cerebellopontine angle microsurgery; epidermoid cyst; epidermoid cyst surgery.

Fig. 1

Intraoperative images. ( A ) Patient position, ( B ) asterion exposure, ( C ) epidermoid cyst identification, ( D ) lesion removal in piecemeal fashion, ( E ) intraoperative neurological monitoring, ( F ) anatomopathological study confirming the diagnosis.