Periorbital Dermoid: A Retrospective Review

Objective: Dermoid cysts are congenital lesions caused by ectoderm becoming trapped in the closing neural tube during embryonic development. They are commonly found at craniofacial sites as a skin lump and have variable extent. The aim was to review characteristics and outcome of periorbital dermoid cysts.

Methods: We present a retrospective review of 13 cases of suspected periorbital dermoid cyst, treated with surgical intervention between 2005 and 2015 in a single center. Baseline demographic information was recorded. We compared the different anatomical distributions, investigations undertaken, surgical approach and management, histological differences, and outcome in each patient.

Results: More than 75% were pediatric patients. The most common location was supraorbital, nasofrontal/glabella and lacrimal gland locations. 100% had pre-operative imaging, with 30% having >1 mode of imaging to determine extent of lesion and whether intracranial or intraorbital extension was present. All cases underwent planning for surgical removal, and most had a local approach. Approach from the eyebrow was frequent and also observed for lateral lesions was temporal approach extending pre-auricularly. No perioperative complications were observed. One case was a reoperation on a recurrence from >20 years ago. No recurrences were observed following surgery.

Conclusion: Clinical history and site of lump are important in determining possible diagnoses. Estimation of size and assessment of local effect and extent are important in pre-operative planning. This allows the most appropriate surgical approach to be undertaken for best cosmetic outcome and minimal complications to the patient.