Epidermoid Cysts (Congenital Cholesteatoma) of the Skull Base
Epidermoid cysts are essentially lumps of skin growing in the skull base. During embryo development, it is thought, that skin cells are trapped within deeper tissues such as the skull base, or around the brain and grow to cause adjacent tissue damage.
These tumours comprise approximately 1% of all intracranial tumours. The congenital cholesteatoma looks like a “mother of pearl”. The tumour grows slowly and it envelopes the surrounding nerves and may eventually put pressure on the brain or the brain lining causing headache. Typically the patient presents with one or combination of the following symptoms: hearing loss, ringing, balance disturbance and facial muscle weakness.
Diagnosis is usually made with high quality CT and MRI imaging (see figure 5). Once the diagnosis is confirmed, two broad management options exist depending on the patient’s general health, tumour size / growth rate and the tumour’s affect on other critical nerves. The SANAMI team will discuss and assess your case on an individual basis depending on these factors and offer one of the two management options. Watchful waiting, where the tumour is closely observed with CT/ MRI scans to see if it is growing. Usually, however, microsurgical excision (+/- nerve grafting) is the gold standard for the removal of these rare and stubborn tumours.
Figure 5 – MRI of skull base epidermoid cyst (congenital cholesteatoma)
Your SANAMI team that assesses epidermoid tumours includes a specialist skull base neurosurgeons and a neurotologist (ear surgeon with specialist acoustic tumour training). The team discusses each case, evaluates the CT/MRI images and offers the most appropriate management option based on each person’s individual circumstance and tumour. Along with your specialist surgical team our group only works with specialist trained neurosurgical anaesthetists, neurosurgical/ neurotological surgical nurses and neurosurgical ICU nurses. If surgery is appropriate for you and you elect to proceed with the operation, then your first post operative night and day will be in one of Australia’s most well respected and largest ICU units, North Shore Private ICU. The rest of your aftercare will be in a specialist neurosurgical post operative ward with neurosurgical nurses.
Patients with a skull base epidermoid expect excellent care. At SANAMI we look forward to providing you with the highest quality, most ethical, comprehensive and compassionate care possible. Visit the SANAMI difference.
|
