[Cholesteatoma of the cerebellopontine angle presented as trigeminal neuralgia]

To explore the effective methods of diagnosis and treatment for cholesteatoma of the cerebellopontine angle presented as trigeminal neuralgia.

The Clinical data of 13 patients were studied retrospectively.

Only 1 case of Cholesteatoma in cerebellopontine and suprasellar cistern was detected with cranial CT scans among 13 patients. Prolonged latency of Wave V and interpeak peak latencies of I-V Wave were recorded in 1 case on auditory brainstem response(ABR). But 9 patients had abnormality in ENG (2 paralysis, 2 paresis). During the operations, we found that cholesteatoma tissue or its capsule wrapped the roots of trigeminal nerves. The cholesteatoma were removed through post-sigmoid sinus approach without partial amputation of trigeminal posterior root. All the patients were clinically cured by extraction of cholesteatoma with following up period of 3 years (10 cases) and half of a year(3 cases). Cholesteatoma extended above tentorium was completely resected with post-sigmoid sinus approach in one case.

ENG is more sensitive than cranial CT and ABR for diagnosis of cholesteatoma in the cerebellopontine angle. The post-sigmoid sinus approach is the best operative approach. It is unnecessary to have the partial amputation of trigeminal posterior root if cholesteatoma can be completely removed. When cholesteatoma extends above tentorium, it can be removed simultaneously by post-sigmoid sinus approach.