Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Forehead Osteoma Excision by Anterior Hairline Incision with Subcutaneous Dissection

  • Kim, Jun Sik (Department of Plastic and Reconstructive Surgery, Institute of Health Sciences, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Lee, Jeong Hwan (Department of Plastic and Reconstructive Surgery, Institute of Health Sciences, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Kim, Nam Gyun (Department of Plastic and Reconstructive Surgery, Institute of Health Sciences, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine) ;
  • Lee, Kyung Suk (Department of Plastic and Reconstructive Surgery, Institute of Health Sciences, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine)
  • Received : 2015.10.09
  • Accepted : 2016.01.26
  • Published : 2016.03.20
Download PDF
⟨ Previous Next ⟩

Abstract

Forehead osteomas are benign but can pose aesthetic and functional problems. These osteomas are resected via bicoronal or endoscopic approach. However, large osteomas cannot be removed via endoscopic approach, and bicoronal approach can result in damage to the supraorbital nerve with resultant numbness in the forehead. We present a new approach to resection of forehead osteomas, with access provided by an anterior hairline incision and subcutaneous dissection. Three patients underwent resection of the forehead osteoma through an anterior hairline incision. The dissection was carried in the subcutaneous plane, and the frontalis muscle and periosteum were divided parallel to the course of supraorbital nerve. The resulting bony defect was re-contoured using $Medpor^{(R)}$. All three patients recovered without any postoperative infection or complication and symptoms. Scalp sensory was preserved. Aesthetic outcomes were satisfactory. Patients remain free of recurrence for 12 months of follow up. The anterior hair line approach with subcutaneous dissection is an effective method for removal of forehead osteoma, since it offers broad visualization and hides the scar in the hairline. In addition, the dissection in the subcutaneous plane avoids inadvertent injury to the deep nerve branches and helps to maintains scalp sensation.

Keywords

References

  1. Jung ES, Pyon JK, Mun GH, Oh KS. Endoscopic excision of forehead masses. J Korean Cleft Palate-Craniofac Assoc 2004;5:141-6.
  2. Steele MH, Suskind DL, Moses M, Kluka E, Liu DC. Orbitofacial masses in children: an endoscopic approach. Arch Otolaryngol Head Neck Surg 2002;128:409-13. https://doi.org/10.1001/archotol.128.4.409
  3. Lee HJ, Shin MS, Park BY, Lim SY, Pyon JK, Bang SI, et al. Multiple osteomas in the skull vault: case report. J Korean Soc Plast Reconstr Surg 2011;38:512-5.
  4. Haddad FS, Haddad GF, Zaatari G. Cranial osteomas: their classification and management: report on a giant osteoma and review of the literature. Surg Neurol 1997;48:143-7. https://doi.org/10.1016/S0090-3019(96)00485-5
  5. Savic DL, Djeric DR. Indications for the surgical treatment of osteomas of the frontal and ethmoid sinuses. Clin Otolaryngol Allied Sci 1990;15:397-404. https://doi.org/10.1111/j.1365-2273.1990.tb00490.x
  6. Mun GH, Jung ES, Lim SY, Hyon WS, Bang SI, Oh KS. Excision of forehead osteomas: experience with 12 patients with use of an endoscopic technique. J Craniofac Surg 2006;17:426-30. https://doi.org/10.1097/00001665-200605000-00007
  7. Chang SC, Chen PK, Chen YR, Chang CN. Treatment of frontal sinus osteoma using a craniofacial approach. Ann Plast Surg 1997;38:455-9. https://doi.org/10.1097/00000637-199705000-00004
  8. Shin JY, Roh SG, Lee NH, Yang KM. A case report in treatment of the frontal sinus osteoma using cranial bone graft. J Korean Soc Plast Reconstr Surg 2010;37:309-12.
  9. Rodriguez ED, Losee JE, Neligan PC. Craniofacial, head and neck surgery, pediatric plastic surgery. In: Neligan PC, Rodriguez ED, Beek AL, Losee JE, editors. Plastic surgery. 3rd ed. London: Elsevier/Saunders; 2013. p. 107-8.