Ann Ital Chir. 2023 Feb 3;12:S2239253X23038288.
To show a case of a giant epidermoid cyst of the posterior fossa treated with a combined microscopic and endoscopic transcranial approach.
A 13-years-old girl presented recurrent episodes of convulsions and vision impairment for years. CT scan and MRI revealed a suprasellar cystic lesion. The patient was operated with a combined microscopic and endoscopic transcranial approach.
Postoperative MRI demonstrated complete resection of the mass and pathology confirmed the preoperative suspicion of epidermoid cyst. Post procedure, the patient recovered well and was discharged. At the 4 week follow up her symptoms had resolved completely.
Epidermoid tumors are congenital lesions with a benign nature. They are the most frequent congenital intracranial lesions. Surgical treatment of epidermoid and dermoid cysts may be challenging. In the recent decades endoscopic endonasal approach (EEA) has been commonly used for the treatment of cranial base lesions because it has several advantages compared to open transcranial approach. We decided to do a transcranial approach combining the use of the microscope with the endoscope because EEA was not possible due to the location of the tumor.
Despite the development of innovative techniques such as the EEA, the transcranial approach remains a viable option, especially when more techniques are combined. In fact, the combination of microscope and endoscope grants the advantages of both tools being very useful to assure a complete excision of intracranial tumors.
Combined Transcranial Approach, Epidermoid Cyst, Posterior Fossa.
展示一例采用联合显微镜和经颅内镜入路治疗的后颅窝巨大表皮样囊肿。
一名 13 岁女孩多年来反复发作癫痫和视力障碍。CT 扫描和 MRI 显示鞍上囊性病变。患者采用联合显微镜和经颅内镜入路进行手术。
术后 MRI 显示肿瘤完全切除，病理证实术前怀疑为表皮样囊肿。术后患者恢复良好出院。4 周随访时，她的症状完全缓解。
表皮样肿瘤是先天性病变，性质良性。它们是最常见的先天性颅内病变。表皮样和皮样囊肿的手术治疗可能具有挑战性。近几十年来，内镜经鼻入路（EEA）已广泛应用于颅底病变的治疗，因为与开颅入路相比，它具有许多优势。我们决定采用联合显微镜和内镜的经颅入路，因为由于肿瘤的位置，无法进行 EEA。
尽管出现了创新技术，如 EEA，但经颅入路仍然是一种可行的选择，尤其是当更多技术联合使用时。事实上，显微镜和内镜的联合使用结合了两种工具的优势，对于确保颅内肿瘤的完全切除非常有用。
联合经颅入路、表皮样囊肿、后颅窝
