title: Orbitofacial masses in children: an endoscopic approach.
abstract: OBJECTIVE
  To describe an endoscopic approach for pediatric orbitofacial masses.
  
  
  METHODS
  A retrospective medical chart review.
  
  
  METHODS
  Tertiary-care children's hospital.
  
  
  METHODS
  Patients (4 boys, 7 girls) ranged in age from 6 months to 11 years. All children underwent endoscopic excision of an orbitofacial mass.
  
  
  METHODS
  A single port approach was used in all but the initial case. The scalp incision was placed approximately 2.0 cm behind the frontal hairline. A subgaleal dissection was performed to minimize risk of nerve injury. Under endoscopic visualization, the mass was resected.
  
  
  METHODS
  Ability to successfully excise the mass endoscopically, and the incidence of complication.
  
  
  RESULTS
  All lesions were successfully resected endoscopically. The surgical time varied from 30 to 105 minutes (mean, 50.5 minutes). Pathologic examination revealed 10 dermoid cysts and 1 neurofibroma. Two children had transient frontalis branch palsies that resolved spontaneously. There was 1 unilateral frontal hypoesthesia in the patient with the neurofibroma (an expected result). There were no other complications.
  
  
  CONCLUSIONS
  An endoscopic approach to pediatric orbitofacial tumors is safe and effective. Although the risk of nerve injury may be higher, a thorough knowledge of frontotemporal anatomy and careful dissection will minimize this risk. The distinct advantage of an endoscopic approach is the absence of any facial scar in these young patients.
authors.affiliation: Division of Otolaryngology, University of Chicago, 5841 S Maryland Ave, MC1035, Chicago, IL 60637, USA.
authors.forename: Matthew H
authors.initials: MH
authors.lastname: Steele
authors.forename: Dana L
authors.initials: DL
authors.lastname: Suskind
authors.forename: Michael
authors.initials: M
authors.lastname: Moses
authors.forename: Evelyn
authors.initials: E
authors.lastname: Kluka
authors.forename: Donald C
authors.initials: DC
authors.lastname: Liu
mesh_terms: D002648:Child; D002675:Child, Preschool; D003884:Dermoid Cyst / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005138:Eyebrows; D005153:Facial Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009455:Neurofibroma / Q000601:surgery*; D009669:Nose Neoplasms / Q000601:surgery*; D009918:Orbital Neoplasms / Q000601:surgery*; D012189:Retrospective Studies