Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
World Neurosurg. 2023 Jul;175:11. doi: 10.1016/j.wneu.2023.03.135. Epub 2023 Apr 6.
Forehead osteomas are benign bone tumors. They are frequently associated with exophytic growth in the outer table of the skull, causing cosmetic disfigurement of the face. The objective of this study was to present the efficacy and feasibility of the endoscopic treatment of forehead osteomas by presenting a case report with details of the surgical technique. A 40-year-old female patient presented with aesthetic complains of a progressing bulge in the forehead. A computed tomography scan with 3-dimensional reconstruction showed bone lesions on the right side of the forehead. The patient underwent surgery under general anesthesia with no noticeable incision, which was planned 2 cm behind the hairline in the midline because the osteoma was close to the midline plane on the forehead (Video 1). A retractor coupled with a 4-mm channel for endoscopy and a 30-degree optic was used to dissect, elevate the pericranium, and locate the 2 bone lesions in the forehead. The lesions were removed using a chisel, endoscopic facelifting raspatory, and a 3-mm burr drill. The tumors were resected completely, resulting in good cosmetic outcomes. The endoscopic approach for treating forehead osteomas is less invasive and facilitates complete removal of tumors, which results in good cosmetic outcomes. Neurosurgeons should consider and add this feasible approach to enhance their surgical armamentarium.
额骨骨瘤是良性骨肿瘤。它们常伴有颅骨外板的外生性生长,导致面部外观畸形。本研究的目的是通过报告一个详细手术技术的病例报告来展示内镜治疗额骨骨瘤的疗效和可行性。一名 40 岁女性患者因额部进行性隆起的美容问题就诊。头部 CT 扫描加三维重建显示右侧额部有骨病变。患者在全身麻醉下接受手术,手术切口不明显,切口位于发际线后 2cm 的中线,因为骨瘤靠近额部中线平面(视频 1)。使用带有内镜通道和 30 度视镜的牵开器解剖、抬起颅骨膜,并定位额部的 2 个骨病变。使用凿子、内镜整容拉钩和 3mm 磨钻切除病变。肿瘤完全切除,美容效果良好。内镜治疗额骨骨瘤的方法具有侵袭性小,可彻底切除肿瘤,从而获得良好的美容效果。神经外科医生应考虑并添加这种可行的方法,以增强他们的手术手段。