Clinical characteristics and surgical outcomes of patients with interdural epidermoid cyst of the cavernous sinus.

Interdural epidermoid cysts of the cavernous sinus originate within the lateral dural wall of the cavernous sinus. Few data are available on the diagnosis and treatment of these tumors. In this study, four patients with interdural epidermoid cyst of the cavernous sinus are reported and data from six patients reported in the English literature are summarized. Trigeminal nerve dysfunction, ophthalmoplegia, and headache were the common symptoms and signs. MRI was the primary diagnostic tool. Contrast enhanced MRI showed slight or strong rim enhancement in six of the 10 patients. All patients were treated by surgical resection using frontotemporal or pterional craniotomy via the intradural or interdural approach. Total removal was achieved in three of the four patients, and four of 10 patients in the whole series. Postoperative neurological function improved in all patients. During follow-up, there were three known clinical recurrences in the total group, but no recurrence in the four patients treated at Qilu Hospital of Shandong University. The findings suggest that aggressive surgical management is associated with good results and with low complication and recurrence rates, but radical resection at the risk of impairing the cranial nerves is not recommended.