Strategy and Efficacy of Whole-Course Neuroendoscopic Surgery for Epidermoid Cysts in the Base of the Skull

Abstract

Abstract Objective: To discuss the strategy and efficacy of neuroendoscopic surgery for the treatment of epidermoid cysts in the base of the skull. Methods: This study retrospectively analyzed the clinical data of 28 patients with epidermoid cysts in the base of their skulls and treated by neuroendoscopic surgery in the Department of Neurosurgery at The First Affiliated Hospital of Bengbu Medical College from January 2015 to April 2022. Of the 28 cases, 22 cases received surgery through the retrosigmoid sinus approach, two cases received surgery through the nasal sphenoidal approach and four cases received surgery through the anterior infratemporal rock approach. Postoperative follow-up was performed to determine the operative effect and record complications. Result: Of the 28 patients, 15 were male and 13 were female; age ranged from 31 to 67 years (mean, 46±7 years). Headache and dizziness were the most common symptoms. Gross-total/near-total resection was performed in 27 cases (96.4%) and subtotal resection in one case (3.6%). The preoperative symptoms of all patients were relieved to varying degrees. With regards to postoperative conditions of the 28 patients; intracranial infection occurred in two patients (7.1%), aseptic meningitis in four patients (14.3%), still right abducens nerve palsy in one patient (3.6%) and acute obstructive hydrocephalus in one patient (3.6%); cerebrospinal fluid rhinorrhea was not observed in any of the patients. During follow-up, one patient (3.6%) developed residual cyst enlargement and one patient (3.6%) developed obstructive hydrocephalus. Conclusion: Neuroendoscopic surgery can significantly improve the resection rate of epidermoid cysts in the base of the skull, reduce trauma and traction on important structures, reduce postoperative complications, shorten the length of hospital stay, and is a safe and effective procedure.