CC BY-NC-ND 4.0 · J Neurol Surg B 2019; 80(S 03): S320-S321
DOI: 10.1055/s-0038-1676998
Skull Base: Operative Videos
Georg Thieme Verlag KG Stuttgart · New York

Retrosigmoid Craniectomy for Resection of Epidermoid causing Trigeminal Neuralgia

Anubhav G. Amin
1  Department of Neurosurgery, Westchester Medical Center Health Network and New York Medical College, Valhalla New York, United States
,
John V. Wainwright
1  Department of Neurosurgery, Westchester Medical Center Health Network and New York Medical College, Valhalla New York, United States
,
Chirag D. Gandhi
1  Department of Neurosurgery, Westchester Medical Center Health Network and New York Medical College, Valhalla New York, United States
,
Christian A. Bowers
1  Department of Neurosurgery, Westchester Medical Center Health Network and New York Medical College, Valhalla New York, United States
› Author Affiliations
Further Information

Address for correspondence

Anubhav G. Amin, MD
Department of Neurosurgery, Westchester Medical Center Health Network and New York Medical College
100 Woods Road, Macy Pavillion
Valhalla, NY 10595-1696
United States   

Publication History

01 June 2018

11 November 2018

Publication Date:
18 February 2019 (online)

 

    Abstract

    The differential diagnosis for trigeminal neuralgia like-symptoms includes cerebellopontine angle lesions causing regional mass effect upon the trigeminal nerve ([Fig. 1]). Here we present an operative video manuscript of a patient experiencing trigeminal neuralgia, secondary to an epidermoid cyst, in which a retrosigmoid craniectomy was performed to resect the epidermoid and decompress the trigeminal nerve ([Fig. 2]). This video highlights the operative nuances to achieving a successful surgery, including appropriate patient positioning, dural exposure to the transverse-sigmoid sinus junction, arachnoid dissection, and decompression of cranial nerves. A gross total resection was achieved; the patient reported immediate relief of facial pain postoperatively and has been pain free at the ten month follow-up.

    The link to the video can be found at: https://youtu.be/Ja2eE0uGk4E.


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    Zoom Image
    Fig. 1 Axial diffusion weighted and axial T2 B-FFE MRI demonstrating a diffusion restricting lesion in the right cerebellopontine angle compressing the root entry zone of the right trigeminal nerve and indenting the pons. B-FFE, balanced fast field echo; MRI, magnetic resonance imaging.
    Zoom Image
    Fig. 2 A right retrosigmoid craniectomy demonstrated a pearly white, friable lesion (arrows) compressing and encasing the trigeminal nerve (*) that was diagnosed as an epidermoid cyst on pathology.

    www.thieme.com/skullbasevideos

    www.thieme.com/jnlsbvideos


    Quality:

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    Conflict of Interest

    None.

    Address for correspondence

    Anubhav G. Amin, MD
    Department of Neurosurgery, Westchester Medical Center Health Network and New York Medical College
    100 Woods Road, Macy Pavillion
    Valhalla, NY 10595-1696
    United States   

      
    Zoom Image
    Fig. 1 Axial diffusion weighted and axial T2 B-FFE MRI demonstrating a diffusion restricting lesion in the right cerebellopontine angle compressing the root entry zone of the right trigeminal nerve and indenting the pons. B-FFE, balanced fast field echo; MRI, magnetic resonance imaging.
    Zoom Image
    Fig. 2 A right retrosigmoid craniectomy demonstrated a pearly white, friable lesion (arrows) compressing and encasing the trigeminal nerve (*) that was diagnosed as an epidermoid cyst on pathology.