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Objective: To assess the long-term surgical results on cranial nerve (CN) function and tumor control in patients harboring cerebellopontine angle (CPA) and petroclival area (PCA) epidermoid cysts (EC).
Methods: This is 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.
Results: 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 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 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). Extent of resection, tumor location and tumor size were not associated with the occurrence of new postoperative CN deficit nor tumor progression.
Conclusion: A functional nerve-sparing resection of posterior fossa EC is an effective strategy to optimize the results on preexisting CN deficits and reduces the risk of permanent de novo deficits.
Keywords
Epidermoid Cyst, Petroclival Area, Cerebellopontine Angle, Cranial Nerve, Functional Outcome, Microsurgery
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CURRENT STATUS: Under Review
Version 1
Posted 01 Nov, 2021
No community comments so far
Reviews received
Received 31 Oct, 2021
Reviewers invited
Invitations sent on 29 Oct, 2021
Editor assigned
On 29 Oct, 2021
First submitted
On 28 Oct, 2021
Version (no preprint)
Posted 29 Jan, 2021
Editorial decision: Major revisions
On 07 Feb, 2021
First submitted
On 03 Jan, 2021
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Subject Areas
Neurosurgery
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This preprint is under consideration at Neurosurgical Review. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 01 Nov, 2021
No community comments so far
Reviews received
Received 31 Oct, 2021
Reviewers invited
Invitations sent on 29 Oct, 2021
Editor assigned
On 29 Oct, 2021
First submitted
On 28 Oct, 2021
Version (no preprint)
Posted 29 Jan, 2021
Editorial decision: Major revisions
On 07 Feb, 2021
First submitted
On 03 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Neurosurgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objective: To assess the long-term surgical results on cranial nerve (CN) function and tumor control in patients harboring cerebellopontine angle (CPA) and petroclival area (PCA) epidermoid cysts (EC).
Methods: This is 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.
Results: 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 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 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). Extent of resection, tumor location and tumor size were not associated with the occurrence of new postoperative CN deficit nor tumor progression.
Conclusion: A functional nerve-sparing resection of posterior fossa EC is an effective strategy to optimize the results on preexisting CN deficits and reduces the risk of permanent de novo deficits.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
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