Endoscopic Excision of Forehead and Eyebrow Benign Tumors in Children

Direct excision of dermoid cysts of the eyebrow and forehead may lead to a prominent facial scar. Endoscopic techniques have greatly reduced the morbidity of excising benign orbitofacial masses. Access, visualization, and dissection of these masses are comparable to open approaches without the use of large or conspicuous incisions. This study evaluates the efficacy of the endoscopic approach in the treatment of dermoid cysts of the eyebrow and defines the place of this approach as an alternative to open surgery.

Between July 2008 and April 2015, a total of 23 pediatric patients (13 females and 10 males) with dermoid cysts of the brow underwent excision by endoscopy. The mean age was 11.9 months (2-32 months). The lesion was located on the lateral brow in 17 cases and on the hairless forehead in 6 cases. To assess osseous involvement, sonography and magnetic resonance imaging study were performed in 22 and 1 case, respectively. Medical photos documentation was done systematically. For those children having an excision of cyst by endoscopy, the operative time, hystopathological examination, specimen size, and hospital stay were evaluated. In addition, parents of these patients were contacted to determine satisfaction with the procedure.

All procedures were successfully performed endoscopically. The mean operative time was 41 minutes (range 17-120 minutes). There was no intraoperative complication. The mean specimen size was 12 mm. In postoperative period, 1 patient presented edema on the forehead with uneventful course. All procedures were performed on the day-surgery. The hystopathological examinations were dermoid cysts in 21 cases, hemangioma in 1 case, and dermatofibroma in 1 case. The mean follow-up was 45.5 months (4-84 months). There was no residual mass or recurrence after long follow-up. Cosmetic results were excellent and all families were pleased with the outcome.

Endoscopic excision of forehead masses and dermoid cysts of the eyebrow is safe and it has proven to be an effective and minimally invasive alternative to the conventional approach. The main advantage of this procedure is the minimization of scar visibility compared with open surgery.