Long term outcome in surgically treated posterior fossa epidermoids

C.V. Gopalakrishnan, K.A. Ansari, S. Nair, G. Menon

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objectives To study posterior fossa epidermoids treated surgically at our institute and to compare their long term outcome with respect to extent of surgical decompression. Materials and methods Retrospective analysis of 50 cases of posterior fossa epidermoid surgically treated at our institute between 1997 and 2007. Results The mean duration from onset of symptoms to surgery was 2.5 years. Patients with cerebellopontine angle (CPA) epidermoids presented predominantly with trigeminal neuralgia (35%) and hearing loss (29%) while patients with fourth ventricle epidermoids had features of raised intracranial pressure (ICP) and gait ataxia (69.2% each). The rate of recurrence was 9% in tumors considered totally removed and 93% in those subtotally removed. Of the 17 patients with recurrences, 3 (7.9%) underwent a second operation. The mean duration of follow up at first recurrence was 9.3 years. Conclusion Based on our experience, the rate of recurrence is significantly higher after subtotal removal as compared to total removal of epidermoids on long-term follow up. Symptomatic recurrence requiring re-exploration is evident only after a long duration (∼10.9 year) following primary surgery. Hence, total removal without producing new neurological deficits should be the standard goal when operating on posterior fossa epidermoid cysts. © 2013 Elsevier B.V. All rights reserved.
Original languageEnglish
Pages (from-to)93-99
Number of pages7
JournalClinical Neurology and Neurosurgery
Volume117
DOIs
Publication statusPublished - 2014

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Recurrence
Gait Ataxia
Cerebellopontine Angle
Fourth Ventricle
Surgical Decompression
Epidermal Cyst
Trigeminal Neuralgia
Intracranial Pressure
Hearing Loss
Neoplasms

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Gopalakrishnan, C.V. ; Ansari, K.A. ; Nair, S. ; Menon, G. / Long term outcome in surgically treated posterior fossa epidermoids. In: Clinical Neurology and Neurosurgery. 2014 ; Vol. 117. pp. 93-99.
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abstract = "Objectives To study posterior fossa epidermoids treated surgically at our institute and to compare their long term outcome with respect to extent of surgical decompression. Materials and methods Retrospective analysis of 50 cases of posterior fossa epidermoid surgically treated at our institute between 1997 and 2007. Results The mean duration from onset of symptoms to surgery was 2.5 years. Patients with cerebellopontine angle (CPA) epidermoids presented predominantly with trigeminal neuralgia (35{\%}) and hearing loss (29{\%}) while patients with fourth ventricle epidermoids had features of raised intracranial pressure (ICP) and gait ataxia (69.2{\%} each). The rate of recurrence was 9{\%} in tumors considered totally removed and 93{\%} in those subtotally removed. Of the 17 patients with recurrences, 3 (7.9{\%}) underwent a second operation. The mean duration of follow up at first recurrence was 9.3 years. Conclusion Based on our experience, the rate of recurrence is significantly higher after subtotal removal as compared to total removal of epidermoids on long-term follow up. Symptomatic recurrence requiring re-exploration is evident only after a long duration (∼10.9 year) following primary surgery. Hence, total removal without producing new neurological deficits should be the standard goal when operating on posterior fossa epidermoid cysts. {\circledC} 2013 Elsevier B.V. All rights reserved.",
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Long term outcome in surgically treated posterior fossa epidermoids. / Gopalakrishnan, C.V.; Ansari, K.A.; Nair, S.; Menon, G.

In: Clinical Neurology and Neurosurgery, Vol. 117, 2014, p. 93-99.

Research output: Contribution to journalArticle

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N2 - Objectives To study posterior fossa epidermoids treated surgically at our institute and to compare their long term outcome with respect to extent of surgical decompression. Materials and methods Retrospective analysis of 50 cases of posterior fossa epidermoid surgically treated at our institute between 1997 and 2007. Results The mean duration from onset of symptoms to surgery was 2.5 years. Patients with cerebellopontine angle (CPA) epidermoids presented predominantly with trigeminal neuralgia (35%) and hearing loss (29%) while patients with fourth ventricle epidermoids had features of raised intracranial pressure (ICP) and gait ataxia (69.2% each). The rate of recurrence was 9% in tumors considered totally removed and 93% in those subtotally removed. Of the 17 patients with recurrences, 3 (7.9%) underwent a second operation. The mean duration of follow up at first recurrence was 9.3 years. Conclusion Based on our experience, the rate of recurrence is significantly higher after subtotal removal as compared to total removal of epidermoids on long-term follow up. Symptomatic recurrence requiring re-exploration is evident only after a long duration (∼10.9 year) following primary surgery. Hence, total removal without producing new neurological deficits should be the standard goal when operating on posterior fossa epidermoid cysts. © 2013 Elsevier B.V. All rights reserved.

AB - Objectives To study posterior fossa epidermoids treated surgically at our institute and to compare their long term outcome with respect to extent of surgical decompression. Materials and methods Retrospective analysis of 50 cases of posterior fossa epidermoid surgically treated at our institute between 1997 and 2007. Results The mean duration from onset of symptoms to surgery was 2.5 years. Patients with cerebellopontine angle (CPA) epidermoids presented predominantly with trigeminal neuralgia (35%) and hearing loss (29%) while patients with fourth ventricle epidermoids had features of raised intracranial pressure (ICP) and gait ataxia (69.2% each). The rate of recurrence was 9% in tumors considered totally removed and 93% in those subtotally removed. Of the 17 patients with recurrences, 3 (7.9%) underwent a second operation. The mean duration of follow up at first recurrence was 9.3 years. Conclusion Based on our experience, the rate of recurrence is significantly higher after subtotal removal as compared to total removal of epidermoids on long-term follow up. Symptomatic recurrence requiring re-exploration is evident only after a long duration (∼10.9 year) following primary surgery. Hence, total removal without producing new neurological deficits should be the standard goal when operating on posterior fossa epidermoid cysts. © 2013 Elsevier B.V. All rights reserved.

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