Anterior transpetrosal approach to the prepontine epidermoids

Yoshinori Shimamoto, Takeshi Kawase, Hikaru Sasaki, Ryuzou Shiobara, Fumito Yamada

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

We have operated on nine patients with a prepontine epidermoid extending to the bilateral cistern or the unilateral middle fossa using the anterior transpetrosal approach since 1986. The preoperative symptoms were unilateral trigeminal neuralgia, hearing disturbance, gait disturbance, double vision, facial hypesthesia, hemifacial spasm, and dysphagia. The most common neurological sign was unilateral trigeminal nerve disturbance. In two patients with useful hearing preoperatively lost, the labyrinth and mastoid air cells as well as the petrous apex were resected to extend the surgical field. Tumors were to tally removed, except for capsules that were tightly adhered to the brain stem, cranial nerve, and vessels. The trigeminal neuralgia, hemifacial spasm, and dysphagia disappeared, but double vision improved only one out of three cases, and facial hypesthesia was unchanged in all cases. There were no postoperative deaths. New abducens palsy appeared in four eases and cerebrospinal fluid (CSF) leakage appeared in three cases postoperatively, but later these symptoms disappeared. In one case, postoperative chemical meningitis developed, and a ventricular shunt was required later to treat hydrocephalus. Postoperative follow-up, an average of 5.7 years, did not show any increases in any of the tumors. Based on our experience, we conclude that the anterior transpetrosal approach is more useful than the retromastoid suboccipital suboccipital approach to resect the epidermoid located mainly in the prepontine cistern.

Original languageEnglish
Pages (from-to)75-80
Number of pages6
JournalSkull Base Surgery
Volume9
Issue number2
Publication statusPublished - 1999

Fingerprint

Hemifacial Spasm
Trigeminal Neuralgia
Diplopia
Hypesthesia
Deglutition Disorders
Hearing
Mastoid
Trigeminal Nerve
Cranial Nerves
Inner Ear
Hydrocephalus
Gait
Meningitis
Brain Stem
Capsules
Neoplasms
Air
Abducens Palsy
Cerebrospinal Fluid Leak

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Shimamoto, Y., Kawase, T., Sasaki, H., Shiobara, R., & Yamada, F. (1999). Anterior transpetrosal approach to the prepontine epidermoids. Skull Base Surgery, 9(2), 75-80.

Anterior transpetrosal approach to the prepontine epidermoids. / Shimamoto, Yoshinori; Kawase, Takeshi; Sasaki, Hikaru; Shiobara, Ryuzou; Yamada, Fumito.

In: Skull Base Surgery, Vol. 9, No. 2, 1999, p. 75-80.

Research output: Contribution to journalArticle

Shimamoto, Y, Kawase, T, Sasaki, H, Shiobara, R & Yamada, F 1999, 'Anterior transpetrosal approach to the prepontine epidermoids', Skull Base Surgery, vol. 9, no. 2, pp. 75-80.
Shimamoto Y, Kawase T, Sasaki H, Shiobara R, Yamada F. Anterior transpetrosal approach to the prepontine epidermoids. Skull Base Surgery. 1999;9(2):75-80.
Shimamoto, Yoshinori ; Kawase, Takeshi ; Sasaki, Hikaru ; Shiobara, Ryuzou ; Yamada, Fumito. / Anterior transpetrosal approach to the prepontine epidermoids. In: Skull Base Surgery. 1999 ; Vol. 9, No. 2. pp. 75-80.
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