Dermoid Cyst with Dr. Rebeccah Brown

Dermoid cysts in the glabella region need imaging, but in the lateral orbital location imaging is unnecessary and moving right to excision is appropriate.

The proximity of the eyebrow can help in covering the scar into the eyebrow line and can lead to a great cosmetic result.

You never want to shave eyebrows, they never grow back right.

The upper eyelid crease can be used as an incision site to hide the scar very well, with enough mobility to dissect up and down to the dermoid cyst.

The extremely mobile tissue along the upper eyelid allows for adequate dissection below the muscular layer to remove the dermoid cyst and can reduce the rate of rupture.

Dermoid cysts are seated in the underlying bone in a scalloped fashion, like sitting in a bowl or cup, and tend to occur in places where bones come together.

Resection with rupture of a dermoid cyst requires extra care to wash out the cavity and remove any obvious remaining portions of the cyst.

After dermoid cyst excision, the surgeon should curette the cavity and the periosteum.

Immobility of a scalp mass narrows the differential diagnosis, taking things like enlarged lymph nodes off the table even though they are relatively common in the parietal region.

For scalp dermoid cysts, imaging is needed to determine if there is intracranial extension.

While dermoid cysts may appear to be tethered to the scalp, the bull-like scallop seating within the bone is what gives it that effect.

Excised dermoid cysts typically have a yellowish, cream cheesy appearance.