Clinical features and treatment strategies of middle cranial fossa epidermoid csyts: a report of 13 cases

Objective To investigate the clinical features and treatment strategies of middle cranial fossa epidermoid cysts and to provide evidences for their clinical diagnosis and treatment. Methods The clinical data of 13 patients with middle cranial fossa epidermoid cysts, admitted to Neurosurgery Department of Lanzhou University Second Hospital from June 2007 to April 2015, were analyzed retrospectively, which included the clinical presentations, characteristics of imaging and pathology, operations and follow-up results. Results Out of 13 patients, 7 patients received complete resection and 6 cases underwent near-complete resection. The postoperative pathological examinations indicated epidermoid cysts in all cases. The 13 patients were followed up for 7-103 months (mean: 40.5±26.1 months). There was no recurrence in 11 cases base on MR examination whose clinical symptoms were relieved or disappeared. Recurrence was suggested by MR in the remaining 2 cases that underwent a second operation and pathological findings revealed inflammatory granuloma in 1 case and recurrence of epidermoid cyst in the other. Conclusions Common symptoms of middle cranial fossa epidermoid cysts include neurological dysfunctions in areas innervated by the trigeminal nerve, which has characteristic imaging manifestation. Near-complete resection through interdural approach might be helpful for maximal protection of neurological functions and reduction of the complications commonly associated with traditional operations. Key words: Epidermoid cysts; Cranial fossa, middle; Treatment outcome; Imaging characteristics