The eyelid crease approach to angular dermoid cysts in pediatric general surgery.

PURPOSE: We recently adopted an approach described by eyelid surgeons for angular dermoid cyst excision. The aim of this study was to compare the outcome of this technique with that accomplished through a conventional trans-eyebrow incision.

METHODS: Prospective nonrandomized study of 34 consecutive children treated between January 2000 and December 2006. Twenty-six patients (group I) were operated on through a trans-eyebrow incision, whereas 8 (group II) received an upper eyelid crease incision. Performance measures included cosmesis, operative time, and complications. Cosmesis was assessed blindly with comparative photographs, using a 100-mm visual analog scale.

RESULTS: No significant differences were found between groups I and II with regard to age at surgery (22 +/- 17 vs 24 +/- 4 months; P = .07) and operative time (42 +/- 21 vs 40 +/- 16 minutes; P = .9). In group II, the scar resulted invisible when the affected side was assessed with the eye open and still significantly better than group I, when evaluated with the eye closed (96 +/- 7 vs 81 +/- 18 mm; P = .0001). All patients and their families reported great satisfaction and an excellent scar. There were neither major postoperative complications nor recurrence of the lesion.

CONCLUSIONS: Angular dermoid cyst excision using an eyelid crease approach yields excellent cosmesis and represents a safe, simple, and easily reproducible procedure in pediatric general surgical practice.