Long-term surgical oncological and functional outcome of large petroclival and cerebellopontine angle epidermoid cysts: a multicenter study - Sorbonne Université
Journal Articles Neurosurgical Review Year : 2022

Long-term surgical oncological and functional outcome of large petroclival and cerebellopontine angle epidermoid cysts: a multicenter study

Aurore Sellier
Lucas Troude
  • Function : Author
Clément Baumgarten
  • Function : Author
Yohan Caudron
  • Function : Author
Maxime Bretonnier
  • Function : Author
Clémentine Gallet
  • Function : Author
Sébastien Boissonneau
  • Function : Author
Pierre-Julien Cungi
  • Function : Author
Xavier Morandi
  • Function : Author
Henry Dufour
  • Function : Author
Henri-Dominique Fournier
  • Function : Author
Emmanuel Gay
  • Function : Author
Pierre-Hugues Roche
  • Function : Author

Abstract

Cranial nerve (CN) disorders are the foremost symptoms in cerebellopontine angle (CPA) and petroclival area (PCA) epidermoid cysts (EC).The aim of this work was to assess the long-term surgical results on CN function and tumor control in these patients. We performed 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. 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 the 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 the 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). The extent of resection, tumor location, and tumor size was not associated with the occurrence of new postoperative CN deficit or tumor progression. A functional nerve-sparing resection of posterior fossa EC is an effective strategy to optimize the results on preexisting CN deficits and reduce the risk of permanent de novo deficits.

Dates and versions

hal-04588514 , version 1 (27-05-2024)

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Aurore Sellier, Lucas Troude, Clément Baumgarten, Yohan Caudron, Maxime Bretonnier, et al.. Long-term surgical oncological and functional outcome of large petroclival and cerebellopontine angle epidermoid cysts: a multicenter study. Neurosurgical Review, 2022, 45 (3), pp.2119-2131. ⟨10.1007/s10143-021-01702-2⟩. ⟨hal-04588514⟩
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