Sir,
The recent report on management of “intracranial epidermoid tumor” is very interesting.[1] Chowdhury et al. concluded “earlier diagnosis and complete excision or near total excision of this benign tumor can cure the patient with the expectation of normal life.”[1] Indeed, there are many present approaches for management of intracranial epidermoid tumor. “What the best way is” has to be further assessed. Focusing on the use of microneurosurgery, it might be the way that balances between too aggressive and too conservative management. An interesting approach is the use of minimally invasive surgery by endoscopy.[2] Tuchman et al. reported their experience on using endoscopic-assisted resection approach for managing intracranial epidermoid tumors “endoscopic-assisted surgery is particularly useful for identifying and removing additional tumor located around surgical corners.”[3] However, to use the microsurgery technique, the important considerations are only the availability of microsurgery tool and experience of practitioners. Furthermore, using microsurgery does not mean that there will be no chance of surgical sequelae. For example, permanent hearing loss following endoscopic-assisted surgery for epidermoid tumors of the cerebellopontine angle can be seen.[4]
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Conflicts of interest
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References
- 1.Chowdhury FH, Haque MR, Sarker MH. Intracranial epidermoid tumor; microneurosurgical management: An experience of 23 cases. Asian J Neurosurg. 2013;8:21–8. doi: 10.4103/1793-5482.110276. [DOI] [PMC free article] [PubMed] [Google Scholar]
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- 4.Schroeder HW, Oertel J, Gaab MR. Endoscope-assisted microsurgical resection of epidermoid tumors of the cerebellopontine angle. J Neurosurg. 2004;101:227–32. doi: 10.3171/jns.2004.101.2.0227. [DOI] [PubMed] [Google Scholar]