{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:06:55Z","timestamp":1784074015228,"version":"3.55.0"},"reference-count":10,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,7,13]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Intracranial epidermoid cysts are rare congenital lesions accounting for approximately 1% of intracranial tumors. Petrous apex involvement is uncommon and surgically challenging because of the lesion\u2019s proximity to critical neurovascular structures. Reports describing minimally invasive endoscope-assisted approaches in this location remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 32-year-old man presented with progressive right-sided otalgia, pulsatile tinnitus, and hearing loss. Imaging demonstrated a destructive petrous temporal bone lesion with atypical diffusion characteristics, initially suspected to represent a jugular foramen tumor. The patient underwent a minimally invasive endoscope-assisted presigmoid burr hole approach. Intraoperatively, the lesion demonstrated the characteristic pearly appearance of an epidermoid cyst and was resected piecemeal under microscopic and endoscopic visualization. Endoscopic assistance improved visualization of deep and angled extensions beyond the microscopic field. Postoperatively, the patient had preserved facial nerve function, stable hearing, and an uneventful recovery. Histopathological examination confirmed an epidermoid cyst.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Petrous apex epidermoid cysts require balancing maximal safe resection with preservation of neurological function. This case highlights the potential utility of a minimally invasive endoscope-assisted approach for improving visualization within constrained skull base corridors while minimizing operative morbidity. Long-term radiological surveillance remains important when complete capsule removal is not safely feasible.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26361\">https:\/\/thejns.org\/doi\/10.3171\/CASE26361<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26361","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:41Z","timestamp":1784073641000},"source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic assisted minimally invasive resection of petrous bone epidermoid cyst via a presigmoid burr hole approach: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"given":"Alaa","family":"Turkistani","sequence":"first","affiliation":[{"name":"Neurosurgery Section, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Jeddah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3311-8091","authenticated-orcid":true,"given":"Badr","family":"Hafiz","sequence":"additional","affiliation":[{"name":"Neurosurgery Section, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Jeddah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal","family":"Muzian","sequence":"additional","affiliation":[{"name":"Department of Surgery, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Khalid","sequence":"additional","affiliation":[{"name":"Neurosurgery Section, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Jeddah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghadeer","family":"Mokhtar","sequence":"additional","affiliation":[{"name":"Department of Pathology, King Faisal Specialist Hospital and Research Centre, Jeddah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0818-5746","authenticated-orcid":true,"given":"Mohammed","family":"Aref","sequence":"additional","affiliation":[{"name":"Neurosurgery Section, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Jeddah"},{"name":"College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"bib1","series-title":"Surg Neurol","first-page":"584","article-title":"Epidermoids of the cerebellopontine angle: a 20-year experience","volume":"70","author":"Schiefer","year":"2008","unstructured":"Schiefer TKLink MJ.Epidermoids of the cerebellopontine angle: a 20-year experience. Surg Neurol. 2008;70(6):584-590. doi:10.1016\/j.surneu.2007.12.021"},{"issue":"3","key":"bib2","series-title":"Otolaryngol Clin North Am","first-page":"479","article-title":"Lesions of the petrous apex: diagnosis and management","volume":"40","author":"Isaacson","year":"2007","unstructured":"Isaacson BKutz JWRoland PS.Lesions of the petrous apex: diagnosis and management. Otolaryngol Clin North Am. 2007;40(3):479-519. doi:10.1016\/j.otc.2007.03.003"},{"issue":"2","key":"bib3","series-title":"Neurosurg Rev","first-page":"259","article-title":"Cerebellopontine angle epidermoid cysts: clinical presentations and surgical outcome","volume":"39","author":"Hasegawa","year":"2016","unstructured":"Hasegawa MNouri MNagahisa SCerebellopontine angle epidermoid cysts: clinical presentations and surgical outcome. Neurosurg Rev. 2016;39(2):259-266. doi:10.1007\/s10143-015-0684-5"},{"issue":"7","key":"bib4","series-title":"Otol Neurotol","first-page":"951","article-title":"Primary epidermoid tumors of the cerebellopontine angle: a review of 47 cases","volume":"37","author":"Yawn","year":"2016","unstructured":"Yawn RJPatel NSDriscoll CLPrimary epidermoid tumors of the cerebellopontine angle: a review of 47 cases. Otol Neurotol. 2016;37(7):951-955. doi:10.1097\/MAO.0000000000001085"},{"issue":"4","key":"bib5","series-title":"Br J Neurosurg","first-page":"451","article-title":"Epidermoid and cholesterol cysts in the apex of the petrous bone","volume":"3","author":"King","year":"1989","unstructured":"King TTBenjamin JCMorrison AW.Epidermoid and cholesterol cysts in the apex of the petrous bone. Br J Neurosurg. 1989;3(4):451-461. doi:10.3109\/02688698909002831"},{"issue":"4","key":"bib6","series-title":"Asian J Neurosurg","first-page":"1288","article-title":"Surgical management of intracranial giant epidermoid cysts in adults: a case-based update","volume":"13","author":"Mangraviti","year":"2018","unstructured":"Mangraviti AMazzucchi EIzzo ASurgical management of intracranial giant epidermoid cysts in adults: a case-based update. Asian J Neurosurg. 2018;13(4):1288-1291. doi:10.4103\/ajns.AJNS_91_18"},{"key":"bib7","series-title":"Surg Neurol Int","first-page":"163","article-title":"Surgical strategy for intracranial dermoid and epidermoid tumors: an experience with 33 patients","volume":"5","author":"Lynch","year":"2014","unstructured":"Lynch JCAversa APereira CNogueira JGon\u00e7alves MLopes H.Surgical strategy for intracranial dermoid and epidermoid tumors: an experience with 33 patients. Surg Neurol Int. 2014;5:163. doi:10.4103\/2152-7806.145764"},{"issue":"1","key":"bib8","series-title":"Sci Rep","first-page":"5818","article-title":"Long term management of intracranial epidermoids balancing extent of resection and functional preservation in a 20 year institutional experience","volume":"15","author":"Omer","year":"2025","unstructured":"Omer MNakagawa JMSales AHALong term management of intracranial epidermoids balancing extent of resection and functional preservation in a 20 year institutional experience. Sci Rep. 2025;15(1):5818. doi:10.1038\/s41598-025-90333-4"},{"issue":"1","key":"bib9","series-title":"J Neurosurg","first-page":"14","article-title":"Surgical treatment of epidermoid cysts of the cerebellopontine angle","volume":"84","author":"Samii","year":"1996","unstructured":"Samii MTatagiba MPiquer JCarvalho GA.Surgical treatment of epidermoid cysts of the cerebellopontine angle. J Neurosurg. 1996;84(1):14-19. doi:10.3171\/jns.1996.84.1.0014"},{"key":"bib10","series-title":"Surg Neurol Int","first-page":"30","article-title":"Intracranial epidermoid cysts: demographics, surgical strategies, and postoperative outcomes in a retrospective cohort study","volume":"16","author":"Faraj","year":"2025","unstructured":"Faraj MK.Intracranial epidermoid cysts: demographics, surgical strategies, and postoperative outcomes in a retrospective cohort study. Surg Neurol Int. 2025;16:30. doi:10.25259\/SNI_1085_2024"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/2\/article-CASE26361.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/2\/article-CASE26361.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/2\/article-CASE26361.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:41Z","timestamp":1784073641000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/2\/article-CASE26361.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,13]]},"references-count":10,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/case26361","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,13]]}}}