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Surgical Correction for Pediatric Epiblepharon and Trichiasis
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Upper blepharoplasty approach to frontozygomatic dermoid cysts.

Kathryn E Nelson1, Anuj Mishra, Christian Duncan

  • 1Department of Plastic Surgery, Alder Hey Children's Hospital, Liverpool, UK. katenelson@doctors.net.uk

The Journal of Craniofacial Surgery
|December 3, 2011
PubMed
Summary

This study demonstrates the effectiveness of frontozygomatic dermoid cyst removal in children using a blepharoplasty incision. The technique offers excellent scar camouflage with no reported lid or ocular dysfunction.

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Area of Science:

  • Ophthalmology
  • Pediatric Surgery
  • Dermatology

Background:

  • Periorbital dermoid cysts are common in children.
  • Traditional surgical approaches for these cysts involve various incisions, potentially leading to visible scarring.

Purpose of the Study:

  • To present Alder Hey Children's Hospital's experience with frontozygomatic dermoid cyst removal via a blepharoplasty incision.
  • To review literature, detail the surgical technique, and explain clinical choices based on anatomy and pathology.

Main Methods:

  • Retrospective review of 34 pediatric patients (ages 1-11) operated on between 2005-2008.
  • Surgical removal of frontozygomatic dermoid cysts through a blepharoplasty incision.
  • Preoperative imaging generally not used unless cyst was >1 cm from brow margin.

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Main Results:

  • Complete excision of all dermoid cysts.
  • Cysts were adherent to periosteum; 3 were subperiosteal, none invaded the orbit.
  • Average operative time was 30 minutes; average follow-up was 1 year.
  • Minor complications included transient ptosis in 3 children; no recurrences.
  • Excellent scar camouflage achieved in all patients.

Conclusions:

  • The blepharoplasty incision approach for frontozygomatic dermoid cyst removal is highly effective.
  • This technique provides superior scar camouflage without compromising lid or ocular function.