Peripheral osteoma on the medial eyebrow successfully extracted while preserving supratrochlear nerve

Area of Science:

• Oral and Maxillofacial Surgery
• Neurosurgery
• Dermatology

Background:

• Osteomas are benign, slow-growing osteogenic tumors common in the head and neck.
• Peripheral osteomas are hypothesized to arise from reactive mechanisms like trauma or muscle traction.
• Understanding the anatomical structures of the craniomaxillofacial region is crucial for surgical intervention.

Observation:

• A 41-year-old woman presented with a painless, slow-growing left eyebrow mass.
• Computed tomography revealed a 2.5 × 2 × 0.7-cm radio-opaque lesion near the left supraorbital foramen.
• The patient had a history of trauma to the area 15 years prior.

Findings:

• A peripheral osteoma was clinically diagnosed based on presentation and imaging.
• Surgical excision was performed using a suprabrow incision.
• A branch of the supratrochlear nerve was identified and preserved during dissection.
• The osteoma was removed in fragments using a chisel and mallet to protect the nerve.

Implications:

• This case underscores the importance of meticulous surgical technique when removing osteomas near critical neurovascular structures.
• Preservation of the supratrochlear nerve is essential to avoid complications and ensure functional and aesthetic outcomes.
• Accurate anatomical knowledge is paramount for surgeons operating in the craniomaxillofacial region to prevent iatrogenic injury.