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Endoscopic excision of benign forehead masses: a novel approach for pediatric general surgeons
Sanjeev Dutta1, H Peter Lorenz, Craig T Albanese
1Division of Pediatric Surgery, Department of Surgery, Lucile Packard Children's Hospital, Stanford University Medical Center, Stanford, CA 94305-5733, USA. sduttal@stanford.edu <sduttal@stanford.edu>
Insights
Pediatric general surgeons can safely remove benign brow and forehead tumors using endoscopic excision, achieving excellent cosmetic results. This technique offers a viable alternative to traditional open surgery for pediatric patients.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Techniques
- Dermatologic Surgery
Background:
- Benign brow and forehead tumors in children are typically excised via overlying incisions by pediatric general surgeons.
- Traditional surgical approaches can lead to suboptimal cosmetic outcomes in pediatric patients.
- Endoscopic brow-lift techniques, utilized by plastic surgeons, offer a potential alternative for lesion removal.
Purpose of the Study:
- To review the experience of a pediatric general surgery practice after adopting endoscopic techniques for benign brow and forehead mass excision.
- To evaluate the safety and efficacy of endoscopic excision for pediatric forehead lesions.
Main Methods:
- Retrospective chart review of 9 consecutive pediatric outpatient procedures (March-October 2005).
- Procedures involved endoscopic excision of lesions (dermoid cysts, pilomatrixomas) using brow-lift equipment through a single scalp incision.
- Outcome measures included operative time, need for conversion, cosmetic results, and complications.
Main Results:
- All 9 lesions were successfully excised endoscopically with no intraoperative or postoperative complications.
- The mean operative time was 56 minutes.
- Families reported high satisfaction with the cosmetic outcomes.
Conclusions:
- Endoscopic excision of forehead masses is a safe and effective procedure for pediatric general surgeons.
- This minimally invasive approach yields excellent cosmetic results in children.
- Endoscopic techniques represent a valuable addition to the surgical armamentarium for pediatric head and neck lesions.
Purpose:
Benign tumors of the brow and forehead are commonly managed by pediatric general surgeons by excision through an overlying incision. Cosmetic results in children can be suboptimal. Plastic surgeons have used endoscopic brow-lift techniques for the removal of these lesions. We review our experience after adopting this endoscopic technique in a pediatric general surgery practice.
Methods:
We conducted a retrospective chart review of 9 consecutive outpatient procedures (5 girls and 4 boys; age range, 5 months to 12 years) between March and October 2005. Seven patients had lesions located on the lateral brow (left, n = 4; right, n = 3), 1 patient had a lesion on the left mid forehead, and 1 patient had a nasoglabellar cyst. All procedures were performed using endoscopic brow-lift equipment through a single small scalp incision 2 cm posterior to the hairline. Outcome measures included need for conversion, operative time, cosmetic outcome, and complications.
Results:
All lesions (6 dermoid cysts and 3 pilomatrixomas) were successfully excised endoscopically. The mean operative time was 56 minutes (range, 22-90 minutes). There was no intraoperative or postoperative complication. All families were pleased with the cosmetic outcomes.
Conclusion:
This case report shows that endoscopic excision of forehead masses is a safe and efficacious procedure in the hands of pediatric general surgeons.
