Endoscopic excision of frontozygomatic dermoid cysts.

A dermoid cyst is a tumor frequently located in the external third of the fronto-orbital region. It develops along the line of embryonic fusion of the naso-optic groove, infolding the ectoderm during embryonic development. The classic treatment is complete surgical resection by means of an external approach on the dome of the cyst; consequently, a visible scar is a permanent esthetic sequel. At present, a new technique for the resection of these cysts by means of endoscope-assisted surgery through one or two small incisions behind the front headline is described. The surgical endoscopic technique is made through three main steps: incision, exposure of the cyst, and removal of the cyst. Eighteen patients were operated on from 1999 through 2001 at the Plastic Surgery Service of Argerich Hospital in Buenos Aires, Argentine. In all 18 patients, local anesthesia was used and no peri-operative complications were observed; postoperative control showed minimal edema, and analgesics were not necessary. Sixteen patients (90%) were controlled 2 years after surgery, and no recurrence was detected. The advantages of endoscopic resection may be summarized as follows: 1) a small and occult hair incision; 2) better visualization and a magnified view of the dissected areas, with the result that injury of important anatomical structures can be easily avoided; and 3) the absence of a facial scar in young patients.