Surgery of intracranial epidermoid cyst (cholesteatoma): An expirience of 15 cases *Author : dr Milenko Stanić Coauthor : dr R. Vujović , dr M. Spaić , dr R. Benović , dr M. Marković , Dr M. Samardžić , dr I. Popović Institution: Department of Neurosurgery, Clinical center Zemun, Belgrade, Serbia

Introduction Intracranial epidermoid cyst are benign lesions representing 1% of all intracranial tumors , developed from ectodermal inclusion. These cysts are potentially curable that are sometimes assosiated with perioperative complications and tend to recur if not completely removed.

Aim To report our experience in surgery of intracranial epidermoid cyst regarding the localization of the tumor, surgical managment strategy with completeness of excision, duration of symptoms and postoperative complication.

Materials and Methods This study retrospectively evaluated on 15 cases of intracranial epidermoid cyst treated between January 2000 to June 2013 at the Department of Neurosurgery Clinical center Zemun follow-up was at least six months

Materials and Methods Analysis patient according to: Sex & age Localisation Degree of resection Duration of symptoms Postoperative complication

Results There were nine male and six female in the series. The average age was 42,6 years . Common clinical presentations included : headache, cerebellar dysfunction, cranial nerve impairment, and seizures. The duration of the disease at admission varied between fifth months to four years.

Results Nine (60%) patients were infartentorial , fifth patients were (33,3%) supratentorial and one patient was supra and infratentorial localization.

Results The resection was total in seven (46,6%) cases and subtotal in eight (53,4%) of cases . Post-operative aseptic/chemical meningitis developed four patients (26.7%) and deterioration of neurological deficit three (20%) patients. Mortality rate was 6,67%.

Postoperative complication Case No Age/Sex Lesion localisation Duration of symptoms Degree of resection Postoperative complication 1.J.N. 48/male CPA 2 years incomplete none 2. Z.B. 52/female parasellar 16 months aseptic meningitis 3. P.M. 63/male diploice 1 year complete 4. J.M. 25/female 5 years 5. N.S. 51/male 9 months VII et VIII cranial lesion 6.M.R. 62/male CPA&parasellar 7.Lj.Z. 46/female fourth venricle 5 months 8.Z.G. 29/male hemiparesis 9. M.J. 52/ female 3 years 10.Z.Ž. 61/female fourth ventricle 6 months 11. V.R. 45/male 12. N.K. 57/female 8 months 13. Z.M. 39/male 12 months 14. R.Z. 36/male 15.G.Z. 20 months

Conclusion Epidermoid cysts are characterized by a long evolution. The diagnosis is relatively characteristic in the imagery Prognosis was favorable with a complete surgical resection.