Abstract
BackgroundDermoids are common benign head and neck cysts in children containing a variety of different skin elements. Current standard treatment is surgical removal that sometimes requires extensive dissection to ensure complete resection and often leaves unwanted facial scarring. A minimally invasive treatment alternative should offer a similar rate of success with a decrease in operative complexity, recovery time and postoperative scarring.ObjectiveTo assess the outcomes of our minimally invasive percutaneous treatment of head and neck dermoids, we reviewed our 9-year interventional radiology (IR) department experience.Materials and methodsThe medical records, imaging and procedural details were reviewed from a cohort of pediatric patients with dermoids treated in our IR department from January 2009 through February 2018. Patients in the study underwent ultrasound (US)-guided cyst puncture, 3% Sotradecol (sodium tetradecyl sulfate [STS]) emulsification of the thick cyst contents allowing complete drainage, and radiofrequency coblation of the cyst wall.ResultsIn this retrospective study, we report on 22 dermoids in 21 patients. The average patient age was 3 years. Twenty-one of the 22 dermoids were successfully treated for an overall success rate of 95%. Four intraosseous dermoids were successfully treated using computed tomography (CT) guidance instead of, or in addition to, US. Average follow-up time was 22 months.ConclusionThe combination of percutaneous cyst drainage using STS as an emulsifying agent followed by radiofrequency coblation is a safe, effective, minimally invasive treatment for pediatric patients with head and neck dermoids.
Highlights
Dermoids are benign cysts containing skin elements such as hair follicles, sweat glands, sebaceous glands and keratinous debris [1,2,3,4,5]
We present our results using a combination of sodium tetradecyl sulfate (STS) emulsification and drainage of cyst contents coupled with radiofrequency coblation of the cyst wall to treat head and neck dermoids
Recurrent or residual dermoids were all identified at the first clinical follow-up visit or imaging session
Summary
Dermoids are benign cysts containing skin elements such as hair follicles, sweat glands, sebaceous glands and keratinous debris [1,2,3,4,5]. They are most commonly diagnosed in childhood and are believed to be the result of faulty embryology [1]. Seven percent of dermoids are located in the head and neck, with the majority in the periorbital, perinasal and temporal regions [6] They have a characteristic clinical presentation usually allowing diagnosis with history and physical. A minimally invasive treatment alternative should offer a similar rate of success with a decrease in operative complexity, recovery time and postoperative scarring
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