Epidermoid Cyst with Bilateral Premedullary Involvement Resected from Left Far-Lateral Approach

The patient is a 51-year-old woman with an epidermoid cyst extending bilaterally along the clivus and cerebellopontine angles from the level of the cisterna magna to the prepeduncular cistern. Her presenting symptoms included hearing loss, tinnitus, and imbalance for 4 months. Near-complete resection of the epidermoid cyst was achieved via a left far-lateral approach. The patient did well after the procedure with no new permanent cranial nerve deficits and unchanged or slightly improved preoperative deficits.