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Endoscopic Excision of Benign Facial Masses in Children: A Review of Outcomes
Deshka Foster1,2, Tiffany J Sinclair1,2, Jordan S Taylor1,2
11 Department of General Surgery, Stanford University School of Medicine , Stanford, California.
Insights
Endoscopic removal of benign pediatric eyebrow and forehead lesions offers excellent cosmetic outcomes. This minimally invasive technique is as safe as open surgery, avoiding facial scars.
Area of Science:
- Pediatric surgery
- Dermatologic surgery
- Minimally invasive surgery
Background:
- Benign eyebrow and forehead masses are common in children.
- Traditional open excision can lead to suboptimal cosmetic results.
- Endoscopic techniques offer a potential alternative for improved cosmesis.
Purpose of the Study:
- To review the center's experience with endoscopic removal of benign facial lesions in pediatric patients.
- To compare the outcomes of endoscopic removal with traditional open excision.
- To evaluate clinical and cosmetic results of both surgical approaches.
Main Methods:
- Retrospective chart review of pediatric cases from 2009-2016.
- Inclusion of both endoscopic and open excision of benign eyebrow or forehead lesions.
- Analysis of clinical and cosmetic outcomes for both groups.
Main Results:
- 40 endoscopic and 25 open excisions were identified.
- Endoscopic cases primarily involved eyebrow dermoid cysts (85%).
- Both methods showed similar complication rates (90% uncomplicated recovery), with endoscopic approach avoiding facial scars.
Conclusions:
- Endoscopic excision is a feasible and effective method for benign pediatric forehead and eyebrow lesions.
- The endoscopic approach yields excellent cosmetic results.
- Complication rates are comparable to open excision, with the advantage of scar avoidance.
Purpose:
Benign masses of the eyebrow and forehead are common in pediatric patients and can result in facial asymmetry, discomfort, or super-infection. Excision is classically conducted via an incision directly over the mass, which can produce sub-optimal cosmesis. Recently, an endoscopic approach using pediatric brow-lift equipment has been adopted. We reviewed our center's experience with endoscopic removal of benign facial lesions and compared these cases with an equivalent series of open cases.
Materials And Methods:
A retrospective chart review was conducted to identify pediatric cases of endoscopic and open removal of benign eyebrow or forehead lesions at our institution from 2009 to 2016. Clinical and cosmetic outcomes were reviewed.
Results:
A total of 40 endoscopic and 25 open cases of excision of benign facial lesions in children were identified. For the patients who underwent endoscopic excision, the majority (85%) presented with a cyst located at the eyebrow. Histologic examination revealed 36 dermoid cysts (90%), 2 epidermal cysts, and 2 pilomatrixomas. Of the 36 cases with post-operative follow-up, 32 patients (89%) had an uncomplicated recovery with good cosmesis. Two patients had an eyebrow droop that resolved without intervention. One patient had localized numbness overlying the site, but no motor deficits. One patient presented with a recurrent dermoid cyst that required open resection. For the patients who underwent open excision, the majority (52%) had dermoid cysts located at the eyebrow. Of the 22 cases with follow-up, 20 of the patients had an uncomplicated recovery (90%). Comparing the rate of complications, there was no statistically significant difference between the two groups (P = 1.0).
Conclusion:
Endoscopic excision of benign forehead and eyebrow lesions in pediatric patients is feasible and yields excellent cosmetic results. When compared with open excision, complication rates are similar between both approaches and a facial scar can be avoided with an endoscopic approach.
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