Excision of high superior lateral dermoid cyst
Richard C. Allen, MD, PhD, FACS
Additional Notes: Length 01:36
This video demonstrates excision of a relatively high superior lateral dermoid cyst. I believe that almost every dermoid can be reached from a lid crease incision. The lid crease is marked, and the 15 blade is used to make an incision through the skin and orbicularis muscle. Dissection is then carried out along the surface of the orbital septum to the superior orbital rim. The dermoid should usually lay in the plane of the periosteum and orbital septum. Once the dermoid is identified superiorly, careful dissection is carried out along the surface of the dermoid cyst. This can be performed with Westcott scissors. In this case, tissue has been left on the surface of the dermoid so that I can fixate it with toothed forceps. If there is some difficulty in doing this, a cryoprobe could be utilized. Usually I will dissect around the dermoid until I find it difficult, then I will move to another spot. The dermoid is excised completely. The goal in the surgery is to excise the dermoid without it rupturing. The lid crease incision can then be closed with simple interrupted 5-0 fast-absorbing sutures.
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