Diagnosis and treatment of epidermoid tumors in the cerebellopontine angle presenting with trigeminal neuralgia

Objective To evaluate the clinical characteristics and surgical outcome of cerebellopontine angle(CPA) epidermoids presenting with trigeminal neuralgia(TN).Methods Between 2003 and 2010,ten patients with typical symptoms of trigeminal neuralgia were found to have CPA epidermoids and treated surgically at our hospital.To analyze retrospectively the clinico-radiological records of these patients.Results Total resection was done in 7 patients(70%),subtotal resection was done in 3 patients.No death related operation.During follow-up,no patients occured recurrence of TN.Conclusions The clinical features of TN from CPA epidermoids are characterized by symptom onset at a younger age compared to TN from vascular causes.In addition to removal of the tumor,the possibility of vascular compression at the root entry zone of the trigeminal nerve will be kept in mind.If it exists,a microvascular decompression(MVD) should be performed.Recurrence of tumor is rare in both total and subtotal removal cases,but long-term follow-up is required.