cerebellopontine angle cholesteatoma resection

Cholesteatoma is more common in the cerebellopontine angle of the cerebellum, with a complete tumor capsule containing silvery epithelial-like tissue, also known as epithelioid cyst or pearloma. Most of the tumors are located in the anterior upper part of the cerebral horn of the cerebellum and the saddle back. They often involve 5, 6, 7, and 8 cranial nerves. When the tumor is huge, the brain stem is compressed. It can still grow on the cerebellum, and extends extensively to the cranial fossa and saddle. On the pool and the bottom of the thalamus. Treatment of diseases: cerebellar stenosis, meningioma Indication Cerebellar ganglion cholesteatoma resection is applicable to: 1. Cholesteatoma located in the cerebral horn of the cerebellum. 2. The tumor has expanded through the cerebellar lobes to the mid-cranial fossa. Contraindications No special contraindications. Preoperative preparation Giant acoustic neuroma has caused increased intracranial pressure, and the ventricular continuous drainage is performed in advance 2 to 3 days before surgery. Surgical procedure 1. Incision and craniotomy. Basically the same as "suboccipital sigmoid sinus approach for acoustic neuroma resection". 2. Incision of the dura mater to explore the tumor, and the tumor was probed from the upper part of the cerebellar hemisphere and the lateral part of the cerebellopontine angle. The tumor capsule is grayish white, the surface is smooth, and the blood vessels are sparse. The tumor capsule often adheres to the cranial nerve, brain stem and vertebrobasilar artery. 3. Excision of the tumor opens the arachnoid surface of the cyst. At the most bulge of the cyst, electrocoagulation is used to cut the capsule, and the silver crumb contents in the capsule are completely removed by a curette or biopsy, and the capsule is made with a small amount of physiological saline. Internal flushing to prevent the contents of the capsule from spreading to the adjacent brain pool. After the tumor wall collapses, the capsule is removed from the posterior cranial fossa, cranial nerve, arterial branch and brain stem with a small stripper and sharp scissors or small scissors, and carefully removed. After the tumor capsule is removed, the trigeminal nerve, the auditory nerve, the midbrain and the pons can be revealed in the region, and the upper part of the slope can be seen. When such tumors have grown to a large extent, after a part of the wall is removed, some of the walls are closely adhered to the structure of the brainstem and vertebral arteries or the arteries and cranial nerves penetrate the capsule, and it is often difficult to completely remove the wall. A small portion of the wall can be retained, but bipolar coagulation weak current electrocoagulation is required to destroy the wall tissue. The portion that grows into the cranial fossa and the upper saddle can be removed through the same incision. 4. Wash the wound, the drainage tube is built into the tumor bed for closed drainage, the dura mater is sutured, and the muscle, subcutaneous tissue and skin are sutured layer by layer. complication 1. May cause 5th, 7th and 8th cranial nerve damage and brain stem injury. 2. concurrent with aseptic meningitis. Occasionally, a few days after surgery, sudden bleeding is considered to be related to the erosion and rupture of blood vessels.