Endoscopically assisted removal of tumors in the frontal region

Background: Advancements in endoscopic surgery, due in part to patient demands and in part to provision of superior medical care by surgeons, have significantly contributed to improvements in patients' quality of life. An endoscopic operation is minimally invasive, associated with faster recovery, and produces less postoperative morbidity. It is a well-accepted procedure in the field of plastic surgery. By applying the principle of endoscopic surgery used in facelift operations, we performed tumor excision in the forehead region. Methods: Two 1.5-cm slit incisions were made in the anterior hairline. One incision was to allow access for the 4.0-mm, 30° endoscope, and the other was for surgical instrumentation. These incisions, determined by the plane of dissection, were more superficial and below the subgaleal layer for soft tissue tumors and deeper into the subperiosteal layer for bone tumors. With good illumination and magnified monitor viewing, the tumors could clearly be visualized and were completely excised. Results: Seven patients with either dermoid cysts (3), osteomas (2), or lipomas (2) underwent endoscopically assisted procedures. In all cases, tumors were successfully excised with no acute or chronic complications. The average postoperative follow-up period was 7 months. No incidence of tumor recurrence was reported. All patients were satisfied with the resultant forehead contour and surgical scars. Conclusions: The main advantage of this procedure is the fact that it is minimally invasive, thus reducing the incidence of injury to the neurovascular structures of the forehead as well as minimization of scar visibility. In conclusion, an endoscope-assisted approach is a good alternative method for managing benign soft-tissue and bone tumors in the forehead and brow region.