Evaluation of Cerebellopontine Angle Epidermoid Presenting with Cranial Nerve Deficit: A Surgical Perspective

CONTEXT: Cerebellopontine angle (CPA) epidermoids are essentially benign tumors, and treatment is complete surgical excision. AIMS: The aim of this study was to evaluate the surgical perspective and outcome analysis of CPA epidermoids. SETTINGS AND DESIGN: This was a retrospective cohort study. SUBJECTS AND METHODS: This study includes a cohort of 15 patients operated for CPA epidermoid in the Department of Neurosurgery of Institute of Medical Sciences, Banaras Hindu University, Varanasi, India, between August 1, 2016, and January 31, 2020. Each patient was evaluated in terms of demographic profile, clinical presentation, surgical management, and postoperative outcome characteristics. STATISTICAL ANALYSIS USED: Unpaired t-test and Chi-square test were used for analysis. Values with P < 0.05 were considered statistically significant. Statistical tests were done using GraphPad Prism version 8.3.0 software. RESULTS: The mean age was 43 years, with the majority of patients being female (56.5%). The most common cranial nerve (CN) involved was CN VIII (67.7%), followed by CN VII (60%). Persisting CN deficit (P = 0.0118) was significantly (P < 0.05) associated with subtotal resection (STR). Gross-total resection was significantly associated (P < 0.05) to CN VII (P = 0.0233) and VIII (P = 0.0157) recovery. CONCLUSIONS: The extent of the tumor excision had no effect on the postoperative morbidity and the risk of recurrence. STR can be considered when there is dense adherence to blood vessels, nerves, or the brain stem to prevent the risk of serious neurological deficits. STR is significantly associated with persisting CN deficit postoperatively. During long-term follow-up, resolution or improvement of neurological deficits may be expected in most patients.