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ENT
Lateral Skull Base Epidermoids
Built from Haynes-Glasscock-Shambaugh Surgery of the Ear, Seventh Edition
What’s inside
5 sections · 71 slides
Nature of the lesion
- Definition and sites of involvement
- Histology and cyst contents
- Growth behaviour and blood supply
- Epidermoid versus dermoid
- Epidermoid versus cholesteatoma
- Petrous bone cholesteatoma in the literature
- Cyst wall of an epidermoid
- Petrous pyramid on the skull base
- Cranial nerves crossing the skull base
Clinical manifestations and diagnosis
- Two clinical groups by location
- Presentation of petrous bone epidermoids
- Differential diagnosis of petrous apex lesions
- CT and MRI characteristics of petrous apex lesions
- CT and MRI characteristics of petrous apex lesions (continued)
- Large epidermoid of the right petrous apex
- Small petrous apex epidermoid eroding the cochlea
- Intradiploic cranial epidermoids
- CT and MRI characteristics of cranial diploic lesions
- Presentation of intradural epidermoids
- Cranial nerve dysfunction in CPA epidermoids
- Mechanism of cranial nerve dysfunction
- Routes of tumour extension
- MRI signal characteristics of epidermoids
- Diffusion-weighted imaging
- Black and white epidermoids
- Cyst content and T2 signal in white epidermoids
- MRI characteristics of posterior fossa lesions
- MRI characteristics of posterior fossa lesions (continued)
- Left cerebellopontine angle epidermoid on MRI
- Foramina of the internal skull base
Management
- Treatment options
- Indications for surgery
- What surgery can and cannot relieve
Surgical technique
- Goals in petrous bone epidermoids
- Surgical approaches to the petrous bone
- Hearing preservation in petrous bone disease
- Classification systems in surgical planning
- Managing residual disease in the temporal bone
- Goals and approach in intradural epidermoids
- Steps of intradural resection
- Irrigation to prevent chemical meningitis
- Endoscope-assisted microsurgery
- Endoscopic technique in the cerebellopontine angle
- When to leave capsule behind
Outcomes
- Outcomes after petrous bone surgery
- Outcomes of petrous bone epidermoids — series, approach and recurrence
- Outcomes of petrous bone epidermoids — hearing
- Outcomes of petrous bone epidermoids — facial nerve
- Outcomes of petrous bone epidermoids — postoperative complications
- Outcomes after intradural surgery
- Outcomes of intracranial epidermoids — resection and recurrence
- Outcomes of intracranial epidermoids — resection and recurrence (continued)
- Outcomes of intracranial epidermoids — postoperative complications
- Outcomes of intracranial epidermoids — postoperative complications (continued)
- Recurrence and extent of resection
- Subtotal resection as a valid alternative
- Aseptic meningitis and hydrocephalus
- Malignant transformation
- Key points
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Haynes-Glasscock-Shambaugh Surgery of the Ear, Seventh Edition
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