Endoscopic assisted microsurgical removal of cerebello-pontine angle and prepontine epidermoid

Cerebello-pontine(CP) angle and prepontine epidermoid tumors are challenging lesions because they grow along the subarachnoid spaces around the very important neurovascular structures and often extend into the supratentorial compartment. They have typically been removed through a variety of anterolateral, lateral, and posterolateral cranial base microsurgical approaches. Sometime they were removed by the endoscope-assisted microneurosurgical (EAM) techniques. Here we report a CP angle and preontine epidermoid tumor extended to supratentorial compartment presented with trigeminal neuralgia that was removed by pure endoscopic visualization through retrosigmoid retromastoid lateral suboccipital approach. (The method of using endoscope along with surgical instruments passing along the sides of endoscope is termed as Endoscope-Controlled Microsurgery–ECM.) So far our knowledge, in the literature this type of report is probably very rare.