{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T02:56:04Z","timestamp":1776308164059,"version":"3.50.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["YNCR2A002"],"award-info":[{"award-number":["YNCR2A002"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Epidermoid cysts (ECs) are one of the most common causes of secondary trigeminal neuralgia (TGN). However, most previous studies have primarily focused on whether complete tumor resection was achieved, and few studies have discussed the primary goal of pain relief.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The present study provides intraoperative strategies for trigeminal nerve (TN) management in patients with TGN secondary to an EC and observed long-term follow-up outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 69 patients with TGN secondary to an EC at our hospitals were included (January 2011\u2013June 2021). The same surgical team performed all surgeries using a retrosigmoid approach. After EC removal, different methods for TN management were used, including microvascular decompression (MVD), sharp capsulectomy, nerve combing and embedded cholesterol crystal excision. The epidemiological, clinical, and surgical data were extracted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total EC removal rate was 92.8% (64\/69). All patients achieved initial pain relief postoperatively, and 12 patients (17.4%) experienced varying degrees of hemifacial hypesthesia, which was relieved within 3\u20136 months. Three patients (4.3%) reported partial pain recurrence within a median follow-up period of 5.5 (0.5\u201310.5) years, which was relieved completely after low-dose carbamazepine administration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The primary goal of surgical tumor removal for patients with TGN secondary to an EC is relief of the main symptom of tormenting pain. The selection of an appropriate strategy for TN, including MVD, sharp capsulectomy, nerve combing or embedded cholesterol crystal excision, should depend on the patient's situation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2022.930261","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T06:16:01Z","timestamp":1658988961000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Strategies for intraoperative management of the trigeminal nerve and long-term follow-up outcomes in patients with trigeminal neuralgia secondary to an intracranial epidermoid cyst"],"prefix":"10.3389","volume":"9","author":[{"given":"Zhenyu","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenhua","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sze Chai","family":"Kwok","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhai","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia","family":"Yin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,28]]},"reference":[{"key":"B1","first-page":"187","article-title":"Differential diagnosis of tumors at the cerebellopontine recess","volume":"83","author":"Gonzalez","year":"1948","journal-title":"Bull Johns Hopkins Hosp"},{"key":"B2","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/BF01650025","article-title":"Intracranial intradural epidermoids and dermoids. Surgical results of 38 cases","volume":"3","author":"Hamel","year":"1980","journal-title":"Neurosurg Rev"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.3171\/jns.1964.21.12.1051","article-title":"Intracranial epidermoids: a study on their distribution and spread","volume":"21","author":"Ulrich","year":"1964","journal-title":"J Neurosurg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/BF01577734","article-title":"Craniocerebral epidermoids and dermoids. A review of 44 cases","volume":"97","author":"Rubin","year":"1989","journal-title":"Acta Neurochir (Wien)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1227\/00006123-198904000-00013","article-title":"Clinical course and surgical prognosis of 33 cases of intracranial epidermoid tumors","volume":"24","author":"Yamakawa","year":"1989","journal-title":"Neurosurgery"},{"key":"B6","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1097\/00006123-199701000-00004","article-title":"Experience with cerebellopontine angle epidermoids","volume":"40","author":"Mohanty","year":"1997","journal-title":"Neurosurgery"},{"key":"B7","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1016\/j.surneu.2007.12.021","article-title":"Epidermoids of the cerebellopontine angle: a 20-year experience","volume":"70","author":"Schiefer","year":"2008","journal-title":"Surg Neurol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1007\/BF01400677","article-title":"Parapontine epidermoid tumours presenting as trigeminal neuralgias: anatomical findings and operative results","volume":"110","author":"Ogleznev","year":"1991","journal-title":"Acta Neurochir (Wien)"},{"key":"B9","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1097\/00006123-199802000-00020","article-title":"Assessment and surgical management of posterior fossa epidermoid tumors: report of 28 cases","volume":"42","author":"Talacchi","year":"1998","journal-title":"Neurosurgery"},{"key":"B10","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1080\/02688697.2020.1867058","article-title":"Surgical management of cerebellopontine angle epidermoid cysts: an institutional experience of 10 years","volume":"36","author":"Vernon","year":"2022","journal-title":"Br J Neurosurg"},{"key":"B11","first-page":"257","article-title":"Cerebellopontine angle epidermoid cysts. Experience of 43 cases with long-term follow-up","volume":"77","author":"Revuelta-Guti\u00e9rrez","year":"2009","journal-title":"Cir Cir"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e508","DOI":"10.1016\/j.wneu.2020.05.226","article-title":"Surgical treatment of secondary trigeminal neuralgia induced by cerebellopontine angle tumors: a single-center experience","volume":"141","author":"Zhang","year":"2020","journal-title":"World Neurosurg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"389","DOI":"10.3109\/10408370490903543","article-title":"Magnetic resonance imaging and proton magnetic resonance spectroscopy of intracranial epidermoid tumors","volume":"45","author":"Nguyen","year":"2004","journal-title":"Crit Rev Comput Tomogr"},{"key":"B14","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1186\/s13014-020-1478-7","article-title":"Multisession radiosurgery for intracranial meningioma treatment: study protocol of a single arm, monocenter, prospective trial","volume":"15","author":"Pinzi","year":"2020","journal-title":"Radiat Oncol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1617","DOI":"10.1007\/s00701-021-04848-6","article-title":"Young-onset trigeminal neuralgia: a clinical study and literature review","volume":"163","author":"Yu","year":"2021","journal-title":"Acta Neurochir (Wien)"},{"key":"B16","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1016\/j.otohns.2004.02.023","article-title":"Surgery of cerebellopontine angle epidermoid cysts: role of the widened retrolabyrinthine approach combined with endoscopy","volume":"131","author":"Darrouzet","year":"2004","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"2465","DOI":"10.1007\/s00701-021-04840-0","article-title":"Importance of appropriate surgical approach selection for radical resection of cerebellopontine angle epidermoid cysts with preservation of cranial nerve functions: our experience of 54 cases","volume":"163","author":"Sakamoto","year":"2021","journal-title":"Acta Neurochir (Wien)"},{"key":"B18","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.wneu.2019.09.008","article-title":"Two-operator endoscopic resection of left cerebellopontine angle epidermoid","volume":"132","author":"Cecchini","year":"2019","journal-title":"World Neurosurg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1055\/s-0035-1558818","article-title":"Whole course neuroendoscopic resection of cerebellopontine angle epidermoid cysts","volume":"77","author":"Hu","year":"2016","journal-title":"J Neurol Surg A Cent Eur Neurosurg"},{"key":"B20","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1097\/00006123-200202000-00008","article-title":"Cerebellopontine angle epidermoids presenting with cranial nerve hyperactive dysfunction: pathogenesis and long-term surgical results in 30 patients","volume":"50","author":"Kobata","year":"2002","journal-title":"Neurosurgery"},{"key":"B21","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.jocn.2010.07.110","article-title":"Surgical treatment of parapontine epidermoid cysts presenting with trigeminal neuralgia","volume":"18","author":"Guo","year":"2011","journal-title":"J Clin Neurosci"},{"key":"B22","first-page":"313","article-title":"Microsurgical management of intracranial epidermoid cysts","volume":"61","author":"Shen","year":"1998","journal-title":"Zhonghua Yi Xue Za Zhi (Taipei)"},{"key":"B23","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1007\/s10143-015-0684-5","article-title":"Cerebellopontine angle epidermoid cysts: clinical presentations and surgical outcome","volume":"39","author":"Hasegawa","year":"2016","journal-title":"Neurosurg Rev"},{"key":"B24","first-page":"81","article-title":"Intracranial epidermoid cysts","volume":"6","author":"Howng","year":"1990","journal-title":"Gaoxiong Yi Xue Ke Xue Za Zhi"},{"key":"B25","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1055\/s-0037-1606220","article-title":"Surgical resection of cerebellopontine epidermoid cysts: limitations and outcome","volume":"79","author":"Farhoud","year":"2018","journal-title":"J Neurol Surg B Skull Base"},{"key":"B26","doi-asserted-by":"publisher","first-page":"E841","DOI":"10.1227\/01.NEU.0000367550.30165.A7","article-title":"Central demyelination in the pathogenesis of trigeminal neuralgia associated with cerebellopontine angle tumors: case report with ultrastructural trigeminal root analysis","volume":"66","author":"Lagares","year":"2010","journal-title":"Neurosurgery"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1703","DOI":"10.1007\/s00701-013-1804-z","article-title":"The long-term outcome of nerve combing for trigeminal neuralgia","volume":"155","author":"Jie","year":"2013","journal-title":"Acta Neurochir (Wien)"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.3171\/2014.12.JNS14469","article-title":"Long-term efficacy and safety of internal neurolysis for trigeminal neuralgia without neurovascular compression","volume":"122","author":"Ko","year":"2015","journal-title":"J Neurosurg"},{"key":"B29","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.neucir.2019.07.003","article-title":"Trigeminal root massage in microsurgical treatment of trigeminal neuralgia patients without arterial compression: when, how and why","volume":"31","author":"Urculo","year":"2020","journal-title":"Neurocirugia (Astur: Engl Ed)"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1540","DOI":"10.1097\/SCS.0000000000000778","article-title":"Cholesteatoma of cerebellopontine angle presented as trigeminal neuralgia","volume":"25","author":"Xia","year":"2014","journal-title":"J Craniofac Surg"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.930261\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T11:06:08Z","timestamp":1659092768000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.930261\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,28]]},"references-count":30,"alternative-id":["10.3389\/fsurg.2022.930261"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2022.930261","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,28]]},"article-number":"930261"}}