Skull pearl tumor resection

Skull epithelioid cysts, also commonly known as cholesteatoma or pearl tumors, originate from ectopic epithelial residual tissue and are less common congenital lesions. The disease can occur at any age, but 20 to 50 years old is the most common. It can occur in any part of the skull, but it occurs in the frontal bone, followed by the parietal or occipital bone. Multiple origins in the skull barrier, so that the bone inside and outside the plate is separated, thinned, and even caused skull defects. As the tumor grows, the tumor can grow into the brain, causing an increase in intracranial pressure and corresponding symptoms. The disease generally grows slowly, but the literature reports that a few have a tendency to malignant, rapid growth, or even ulceration, or by lymphatic metastasis, most advocate early surgical resection. Treatment of diseases: epithelioid cysts Indication Patients with cranial epithelioid cysts diagnosed by clinical symptoms, signs and X-ray and CT, MRI should be removed. Preoperative preparation 1. Skin preparation, wash the head with soap and water 1 day before the operation, and shave the hair on the morning of the operation. You can also shave your head on the eve of surgery. 2. Fasting the morning of surgery. 3. Oral 0.1g can be given to phenobarbital before surgery to ensure a quiet rest. One hour before the operation, 0.1 g of phenobarbital, 0.4 mg of atropine or 0.3 mg of scopolamine were intramuscularly injected. Surgical procedure Scalp incision According to the extent of the lesion, the corresponding flap incision is made. After the cap-like diaphragm is cut, the flap is turned to one side. 2. Lesion revealed After opening the flap, you can see the bulge or damaged skull outer plate, push the periosteum, open the raised outer plate, or use the rongeur to enlarge the bone window from the outer plate damage, that is, expose the tumor. 3. Resection of the tumor Peel off along the tumor wall and completely remove the tumor. If the wall of the capsule adheres tightly to the skull, the wall of the capsule is cut open, the tumor is removed by a tumor forceps, and the wall of the capsule attached to the skull or the surface of the dura mater is scraped off with a curette to achieve complete removal of the tumor. The tumor bed should be protected by surrounding brain cotton, 10% formaldehyde, 75% ethanol or 0.3 stone carbonate, and then rinsed with normal saline to reduce recurrence. If the tumor is intact and no damage is found, a bone hole can be drilled around the tumor, a circle is circled around the tumor, the tumor is separated along the dura mater, and the tumor is removed together with the skull to reduce the recurrence rate. If the tumor does not break the skull, the inner plate is destroyed, the outer plate is still intact, and it is estimated that there is no adhesion between the dura mater and the skull. Four holes can be drilled in the normal skull around the tumor, the wire saw is sawed, and the tumor is separated along the dura mater. The tumor was removed together with the skull flap. If the wall of the capsule adheres tightly to the dura mater and is not easily peeled off, the dura mater can be removed along with the tumor wall, and no forced stripping is performed to avoid bleeding or injury to the brain tissue. The dural defect is repaired with the temporalis fascia, bone flap, dural outer layer, thigh fascia, or dura mater substitute. If the tumor invades the dura mater and causes compression of the cerebral cortex, the dura mater can be cut along the edge of the tumor, and the dura mater can be removed while the dura mater is removed together with the tumor. The dural defect was repaired according to the above method. If the tumor and the dura mater are tightly attached, and the sinus is involved, it is difficult to completely remove the sinus, it is inevitable to scrape off, so as not to cause unnecessary bleeding and damage. At this time, bipolar or unipolar electrocoagulation can be used, or the residual cyst wall can be applied with 10% formaldehyde solution, 0.3% stearic acid and 75% ethanol to reduce recurrence. 4. Defective skull repair The tumor has been completely removed, there is no sign of infection before surgery, and a repair can be done at the skull defect. However, those who have had infection or sinus formation before surgery should not be repaired. After the surgical incision healed for 1 year, the skull was formed. 5. Suture incision After completely stopping the bleeding, the porous rubber tube is drained, and the other hole is taken out from the incision. The cap-like diaphragm and skin are sutured layer by layer. complication 1. Rebleeding, hematoma formation, can cause disturbance of consciousness, and even hemiplegia. 2. Incision infection or skull infection.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.