Surgical Strategy for Dermoid and Epidermoid Tumors of the Posterior Fossa - Experience with 21 Patients

• Main Authors: José Carlos Lynch, Leonardo C. Welling, Antonio Aversa, Celestino Esteves, Jânio Nogueira, Mariângela Gonçalves, Hélio Lopes
• Format: Article
• Language: English
• Published: Thieme Revinter Publicações Ltda. 2017-08-01
• Series: Brazilian Neurosurgery
• Subjects: dermoid tumor; epidermoid tumor; intracranial tumor; microsurgery; posterior fossa
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1606292

Abstract Objective The aim of this paper is to describe our surgical strategy and technique and to identify the best management for posterior fossa dermoid and epidermoid tumors (PFDETs). Methods We retrospectively identified 21 consecutive patients (11 males and 10 females), with a mean age of 33.2 years, a mean follow-up of 6.1 years, and pathologically confirmed PFDETs. Total 17 patients were submitted to the extended retrosigmoid approach. This approach incorporates transverse sigmoid sinus exposure and a generous mastoidectomy. Results Gross total tumor removal was achieved in 16 (76.1%) cases, with no surgical mortality and a recurrence rate of 9.5%. Conclusions The surgical strategies used in this group of patients enabled the total removal of most tumors without surgical mortality and with minimal morbidity and recurrence rates. The extended retrosigmoid approach used is an alternative path regarding cranial base approaches. This approach is quick, simple and safe, and decreases the retraction of the cerebellum.