Endoscopic resection of intracranial dermoid and epidermoid tumors from a minimally invasive perspective

Abstract

Aims:Intracranial dermoid and epidermoid tumors (IDETs), benign, congenital lesions, are traditionally treated using open surgery. However, total resection (TR) can be difficult due to adhesions to surrounding structures. While endoscopic surgery has emerged as a less invasive approach, its success may differ across centers. This study evaluated the outcomes of IDET endoscopic surgery cases and compared them with the literature.Methods:We retrospectively reviewed patients who underwent an operation for epidermoid and dermoid tumors using an endoscopic approach from 2010 to 2020. Age, sex, tumor location, tumor size, surgical approach, resection rates, intraoperative and postoperative complications, length of hospital stay and recurrence rates of the cases were evaluated.Results:The study included 18 patients (mean±standard deviation age: 39.6±15.5 years, age range 15-68 years, male sex: n=12, 66.6%). The tumor locations were 2 temporal (11.1%), 2 frontal (11.1%), and 1 occipital (5.5%) (all intraparenchymal); 2 frontobasal (11.1%), 3 suprasellar (16.6%), 2 lateral orbital (11.1%), 1 intraorbital (5.5%), 3 cerebellopontine angle (16.6%), and 1 located in the lateral ventricle (5.5%); and 1 located in the third ventricle (5.5%). TR, near-TR and subtotal resection were performed in 7 (38.8%), 5 (27.7%), and 6 (33.3%) cases, respectively. No postoperative complication was recorded except for one patient who develpped rhinorrhea and pneumocephaly. No intraoperative complication was recorded. The mean length of hospital stay was 7.9 days (range, 5-28 days).Conclusions:IDETs can be treated by endoscopic approaches, without the need for large incisions and craniotomy in open approaches. Decreased hospital stay seems to be the primary advantage of endoscopic surgery.

Keywords

• intracranial dermoid and epidermoid tumors
• endoscopic approach
• minimally invasive surgery