{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:01:11Z","timestamp":1792054871183,"version":"4.4.0"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,5,17]],"date-time":"2016-05-17T00:00:00Z","timestamp":1463443200000},"content-version":"vor","delay-in-days":4338,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2004,7]]},"abstract":"<jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>To evaluate the use of the retrolabyrinthine approach (RLA) combined with endoscopy with particular reference to preservation of cranial nerve function and completeness of excision in surgery of epidermoid cysts.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A retrospective study was performed on a series of 8 consecutive patients of whom 7 have undergone surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>MAIN OUTCOME MEASURES<\/jats:title><jats:p>Measures include audiological and neurological status preoperatively and postoperatively, size of the lesion, the surgical approach, completeness of excision, and operative morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The tumors were all large, ranging from 2 \u00d7 3\u00a0cm to 6 \u00d7 6\u00a0cm. Presenting symptoms were headache (75%), dysequilibrium (62%), trigeminal nerve palsy (38%), abducens nerve palsy (25%), and, rarely, auditory symptoms. Seven patients underwent surgery, 5 by the RLA, 1 by a translabyrinthine approach (TLA), and 1 by a transcochlear approach. Complete excision was achieved in 5 of the 7 patients. A transtentorial approach was combined in 2 cases (1 RLA, 1 TLA). Endoscopy was used in 3 cases. It allowed a complete tumor excision. One case of keratinous meningitis was observed. Trigeminal nerve function returned to normal in all patients. Postoperative facial nerve function was grade I in 5 cases and grade III in 2 cases. Hearing was preserved in 3 cases as class A, 1 case as class B. In the 2 cases presenting with abducens nerve palsy preoperative symptoms were initially aggravated before returning to normal function by 1 year postoperatively. The RLA with endoscopy allowed less invasive surgery and preservation of hearing in 4 of the 5 cases where it was attempted. Tumor control appeared better than with the suboccipital approach. Mortality and postoperative morbidity also appear reduced.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>RLA combined with endoscopy should be considered as the standard approach for excision of epidermoid cysts. Extension of this approach into a TLA or transcochlear approach will depend on preoperative difficulties and preoperative hearing.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.otohns.2004.02.023","type":"journal-article","created":{"date-parts":[[2004,7,9]],"date-time":"2004-07-09T11:09:41Z","timestamp":1089371381000},"page":"120-125","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Surgery of Cerebellopontine Angle Epidermoid Cysts: Role of the Widened Retrolabyrinthine Approach Combined with Endoscopy"],"prefix":"10.1002","volume":"131","author":[{"given":"Vincent","family":"Darrouzet","sequence":"first","affiliation":[{"name":"Royal Darwin Hospital Darwin Australia"},{"name":"Department of Skull Base Surgery University Clinic of Otolaryngology University Hospital of Bordeaux Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Franco\u2010Vidal","sequence":"additional","affiliation":[{"name":"Royal Darwin Hospital Darwin Australia"},{"name":"Department of Skull Base Surgery University Clinic of Otolaryngology University Hospital of Bordeaux Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"Hilton","sequence":"additional","affiliation":[{"name":"Royal Darwin Hospital Darwin Australia"},{"name":"Department of Skull Base Surgery University Clinic of Otolaryngology University Hospital of Bordeaux Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinh\u2010Qui","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Royal Darwin Hospital Darwin Australia"},{"name":"Department of Skull Base Surgery University Clinic of Otolaryngology University Hospital of Bordeaux Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Lacher\u2010Fougere","sequence":"additional","affiliation":[{"name":"Royal Darwin Hospital Darwin Australia"},{"name":"Department of Skull Base Surgery University Clinic of Otolaryngology University Hospital of Bordeaux Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Guerin","sequence":"additional","affiliation":[{"name":"Royal Darwin Hospital Darwin Australia"},{"name":"Department of Skull Base Surgery University Clinic of Otolaryngology University Hospital of Bordeaux Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Pierre","family":"Bebear","sequence":"additional","affiliation":[{"name":"Royal Darwin Hospital Darwin Australia"},{"name":"Department of Skull Base Surgery University Clinic of Otolaryngology University Hospital of Bordeaux Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,5,17]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"353","volume-title":"Neurosurgery of the ear and skull base","author":"De la Cruz A.","year":"1982"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1977.47.1.0012"},{"key":"e_1_2_6_4_1","first-page":"340","volume-title":"Neurological surgery of the ear. 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