Microsurgical treatment of epidermoid cysts at the cerebellopontine angle

Objective:To summarize the microsurgical approach of the epidermoid cyst at the cerebellopontine angle and the endoscopic assisted microneurosurgery.Methods:Twenty eight cases of epidermoid cysts at the cerebellopontine angle were treated with different approaches,including suboccipital retrosigmoidal approach in 16 cases,subtemporal transtentorial approach in 10 cases and 2 cases of combined supra and infra tentorial approach. Five of which were treated with endocopic assisted microneeurosurgery.Results:Total removal of the tumor was achieved in 21 patients, subtotal removal in 7 patients. There was no surgical motality.Conclusion:Suboccipital retrosigmoidal approach is suitable for epidermoid cyst located in CPA and the tumors extend from CPA to clivus region. Subtemopral transtentorial approach is suitable to treat epidermoid cyst invaded sellar and/or clivus region. Combined supra- and infratentorial approach is suitable for huge epidermoid cyst involved CPA, sellar region even extended to infra clivus area. Furthermore, endoscope assisted microneurosurgery can reduce the operation damage and increase the total resection rate of tumors.