Engler John, Bassani Luigi, Ma Tracy, Tanweer Omar, Elliott Robert E, Harter David H, Wisoff Jeffrey H
Department of Neurosurgery, New York University Langone Medical Center, 317 East 34th Street, New York, NY, 10016, USA.
Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
Childs Nerv Syst. 2016 Dec;32(12):2351-2356. doi: 10.1007/s00381-016-3221-0. Epub 2016 Aug 22.
Dermoid and epidermoid cysts rank among the most common pediatric tumors. We analyzed the outcomes of surgical excision of dermal and epidermal inclusion cysts in a large consecutive series of children.
We retrospectively reviewed 128 consecutive children who underwent calvarial inclusion cyst resection between 2000 and 2010 at NYU Langone Medical Center. Demographic information, neurological exam, lesion location, lesion diameter, type of treatment, extent of resection, time of follow-up, and recurrence were collected.
The cohort includes 67 girls (52.3 %) and 61 boys (47.7 %). Age at diagnosis ranged from birth to 6.5 years (mean of 1.2 years) with surgical intervention between 1 month and 20 years of age (1.5 ± 2.1). Of the 128 patients, 107 underwent open resection. Surgical approach was determined by the senior surgeon. Location, postoperative cosmesis, and family preference were the determining factors. Endoscopic resection was favored with supraorbital and glabellar lesions (75 % endoscopic versus 25 % open) using a rigid scope via a single incision. Erosion of the outer table and involvement of the inner table was noted in 20 patients (15 %), 14 of which were reconstructed using a split thickness calvarial graft. These lesions were noted to be significantly larger than lesions where cranioplasty was not used (1.9 ± 2.81 cm versus 1.23 ± 0.98 cm, p = 0.022). Gross total resection was achieved in all cases.
Complete removal and cure from dermoid and epidermoid inclusion cysts are possible. Complications are few. Endoscopic approaches are useful to improve cosmesis and limit tissue damage for lesions near the orbits.
皮样囊肿和表皮样囊肿是最常见的儿科肿瘤之一。我们分析了一大组连续儿童患者中真皮和表皮包涵囊肿手术切除的结果。
我们回顾性分析了2000年至2010年在纽约大学朗格尼医学中心接受颅骨包涵囊肿切除术的128例连续儿童患者。收集了人口统计学信息、神经系统检查、病变位置、病变直径、治疗类型、切除范围、随访时间和复发情况。
该队列包括67名女孩（52.3%）和61名男孩（47.7%）。诊断时的年龄范围为出生至6.5岁（平均1.2岁），手术干预年龄在1个月至20岁之间（1.5±2.1）。128例患者中，107例行开放切除术。手术方式由资深外科医生决定。位置、术后美容效果和家庭偏好是决定因素。对于眶上和眉间病变，采用硬镜经单切口进行内镜切除更受青睐（75%为内镜切除，25%为开放切除）。20例患者（15%）出现外板侵蚀和内板受累，其中14例采用分层颅骨移植进行重建。这些病变明显大于未进行颅骨成形术的病变（1.9±2.81 cm对1.23±0.98 cm，p = 0.022）。所有病例均实现了大体全切。
皮样囊肿和表皮样包涵囊肿可以完全切除并治愈。并发症很少。内镜手术方法有助于改善美容效果并减少眼眶附近病变的组织损伤。
