Surgical treatment of epidermoid cysts of the cerebellopontine angle

A total of 40 patients with epidermoid cysts of the cerebellopontine angle (CPA) underwent surgery between 1980 and 1993. Total resection was achieved in 30 cases (75%); in 10 cases (25%) parts of the cyst capsule were left because they adhered to the brainstem and vascular structures of the CPA. One patient with very large bilateral epidermoid cysts, who underwent complete bilateral resection in one stage, died of pulmonary aspiration and infection. As of their latest clinical and radiological follow-up examinations (mean 5.7 years), 93% of the patients are able to lead useful lives. Three cases of cyst regrowth have been observed thus far. Modem radiological tools and microsurgery techniques have considerably improved the completeness of cyst resection and reduced postoperative mortality and morbidity rates; however, there still are some cases in which complete resection is impossible without producing severe neurological deficits.