![]() ![]() ↑ 7.0 7.1 7.2 Shields J and Shields C.Ophthalmic Pathology and Intraocular Tumors. ↑ 6.0 6.1 Basic Clinical and Science Course.Orbital dermoids: clinical presentation and management. Orbital Dermoid Cyst of Childhood: Clinical Pathologic Findings, Classification and Management. Prognosis is excellent following successful early surgical intervention. Notice significant periocular and eyelid ecchymosis that developed immediately after dermoid cyst surgical removal Prognosis ![]() ![]() They inflammation from remaining dermoid tissue may also result in an orbitocutaneous fistula. If incompletely removed, cysts may recur or lead to abscess formation. Cysts extending through bony sutures often cannot be removed without rupture. This can be mitigated by copious irrigation at the time of surgery. If the cyst ruptures during surgery, a lipogranulomatous inflammatory reaction may occur. Rarely it is massive like in the figure presented here. Various amounts of ecchymosis is common after surgical removal. If possible, the surgeon attempts to remove the cyst in total without rupture. For deep lesions, anterior, lateral, or combined orbitotomy is indicated. For superficial lesions, an incision in the eyebrow, upper eyelid crease or directly over the lesion is often used. However, some surgeons opt for early excision to avoid the risk of traumatic rupture in the future. They may stabilize or even decrease in size over years. Small, asymptomatic cysts may not require treatment. Immediately after dermoid cyst removal General treatment Differential diagnosis of lateral lesions includes lacrimal tumors. Medial lesions in infants may be confused with congenital encephaloceles, dacryoceles, and mucoceles. Computed tomography can also rule out a dumbbell configuration, with part of the lesion in the orbit and part in the temporal fossa, connected through a bony defect at the suture line. Bony remodeling is present in 85% of cases. It is described as a well-circumscribed lesion with a hyperdense wall and hypodense contents. If a deeper cyst is suspected, a computed tomography (CT) or magnetic resonance imaging (MRI) is indicated. ĭermoids, especially if superficial, may be diagnosed through physical exam.
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