Infratentorial epidermoid cysts treatment: an overview of 94 observations
EANS Academy. Fedirko V. 09/27/19; 276020; EP04122
Prof. Volodymyr Fedirko
Prof. Volodymyr Fedirko

Access to this content is reserved for EANS members and attendees of this event. Click here to become an EANS member and gain your access to the full content of the EANS Academy

Discussion Forum (0)
Rate & Comment (0)
Intracranial epidermoid tumors are rare entities accounting for 0.2-1% of all intracranial neoplasms. Majority of cases are located infratentorially.
Materials and methods: There were 94 patients with epidermoid tumors treated in Romodanov Neurosurgery Institute since 1955 till 2018. 68 (72.3%) were located in CPA, 26 (27.7%) - in the area of 4th ventricle and big cistern. 11 tumors (11.7%) had supratenrorial expansion.
Results: 60 years' experience demands to distinguish three periods on the basis of surgical and anesthesiological techniques. First - «premicrosurgical» 1955-1985 (31 observation). Postoperative morality 41.9% and 36% aseptic meningitis were concordant with more radical extent of resection. Total excision was done in 22%, subtotal - in 67%, partial - in 11% of cases. Next «microsurgical» period 1986-2005 included 22 observations. It was marked by more precise and meticulous microsurgical techniques introduced into routine practice together with advances in diagnostics and anesthesia, associated with introduction of prophylactic steroids use had led to dramatic drop of postoperative mortality to 9% as well as aseptic meningitis rate. There was a decline in surgical aggression with 14.2% of total, 62.3% subtotal and 23.5% of partial excisions. Recurrences was seen at 7.6% of patients during 1955-2005. 2006-2018 time-span was named as «micro-endoscopic» period with vast introduction and development of endoscopic techniques simultaneously with well-established microsurgical standards. It resulted in convergence of increased total resection rates and low mortality and morbidity. Total resection was achieved in 44%, subtotal - in 44%, partial - in 12%. Postoperative mortality reached 2.4% (1 patient). But aseptic meningitis is still an intimidating trouble with 12.1% morbidity rate (5 observations).
Conclusions: Epidermoid tumors are very specific pathology with tricky natural history and perioperative behavior. It mandates meticulous multifactorial assessment, balancing between neurological outcome and extent of resection with regards to aseptic meningitis prophylaxis and management.
Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.

Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.

Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.

Save Settings