Jung Soyeon, Jung Sung Won, Koh Sung Hoon, Lim Hyoseob
Department of Plastic and Reconstructive Surgery, Sacred Heart Hospital, Hallym University Medical Center, Hallym University, Anyang, South Korea.
J Craniofac Surg. 2016 Mar;27(2):e215-7. doi: 10.1097/SCS.0000000000002292.
Patients with forehead mass have a cosmetic problem because the forehead is an important first impression. Conventional skin approach results in visible scar even though surgeons designed the incision along the relaxed skin tension line1. Since Onishi introduced the technique for endoscopic approach in 1995, endoscopic surgery has become rapidly popular in the field of plastic surgery. Endoscopic approach to the forehead mass by small incision on the scalp behind hair line is big advantageous for leaving less ugly scar on the forehead. All procedures need to be identified under the endoscopic visualization. When it was completed, the mass was pulled out. The authors also used the osteotome or rasp when it was the osteoma. The forehead and scalp were applied compressive dressing to prevent hematoma and swelling for 2 days. The cosmesis was excellent because they have no visible scar on the forehead. Endoscopic approaching technique is getting popular and commonly used during the cosmetic surgery because it has many advantages. This method also, however, has difficulties to remove large-sized mass and to perform caudal dissection, and for increased operative times. Furthermore, there are complication of incomplete removal, hematoma, and swelling. The proper candidate is the patient with smooth forehead, with a mobile and soft mass, with a propensity for keloid formation, or hypertrophic scarring. Endoscopic technique is not only advantageous but also disadvantageous. That is why surgeon's selection is more important.
前额肿物患者存在美容问题，因为前额给人的第一印象很重要。传统的皮肤切口方法即使外科医生沿着皮肤松弛张力线设计切口，也会留下明显的疤痕。自1995年大西介绍了内镜手术技术以来，内镜手术在整形外科领域迅速普及。通过发际线后方头皮上的小切口对前额肿物进行内镜手术，对于在前额留下较少难看的疤痕具有很大优势。所有操作都需要在内镜可视化下进行。完成后，将肿物取出。如果是骨瘤，作者还会使用骨凿或锉刀。前额和头皮进行加压包扎2天，以防止血肿和肿胀。由于前额没有可见疤痕，美容效果极佳。内镜手术方法因其诸多优点在美容手术中越来越受欢迎且被广泛应用。然而，这种方法在切除大型肿物、进行尾侧解剖以及增加手术时间方面也存在困难。此外，还存在切除不完全、血肿和肿胀等并发症。合适的手术对象是前额平滑、肿物活动且质地柔软、有瘢痕疙瘩形成倾向或肥厚性瘢痕形成倾向的患者。内镜技术既有优势也有劣势。这就是为什么外科医生的选择更为重要。
