title: The eyelid crease approach to angular dermoid cysts in pediatric general surgery.
abstract: OBJECTIVE
  We recently adopted an approach described by eyelid surgeons for angular dermoid cyst excision. The aim of this study was to compare the outcome of this technique with that accomplished through a conventional trans-eyebrow incision.
  
  
  METHODS
  Prospective nonrandomized study of 34 consecutive children treated between January 2000 and December 2006. Twenty-six patients (group I) were operated on through a trans-eyebrow incision, whereas 8 (group II) received an upper eyelid crease incision. Performance measures included cosmesis, operative time, and complications. Cosmesis was assessed blindly with comparative photographs, using a 100-mm visual analog scale.
  
  
  RESULTS
  No significant differences were found between groups I and II with regard to age at surgery (22 +/- 17 vs 24 +/- 4 months; P = .07) and operative time (42 +/- 21 vs 40 +/- 16 minutes; P = .9). In group II, the scar resulted invisible when the affected side was assessed with the eye open and still significantly better than group I, when evaluated with the eye closed (96 +/- 7 vs 81 +/- 18 mm; P = .0001). All patients and their families reported great satisfaction and an excellent scar. There were neither major postoperative complications nor recurrence of the lesion.
  
  
  CONCLUSIONS
  Angular dermoid cyst excision using an eyelid crease approach yields excellent cosmesis and represents a safe, simple, and easily reproducible procedure in pediatric general surgical practice.
authors.affiliation: Pediatric Surgery Unit, University of Rome La Sapienza, Azienda Policlinico Umberto I, RM 00161 Rome, Italy. da.cozzi@uniroma1.it
authors.forename: Denis A
authors.initials: DA
authors.lastname: Cozzi
authors.forename: Ermelinda
authors.initials: E
authors.lastname: Mele
authors.forename: Giuseppe
authors.initials: G
authors.lastname: d'Ambrosio
authors.forename: Giorgia
authors.initials: G
authors.lastname: Totonelli
authors.forename: Simone
authors.initials: S
authors.lastname: Frediani
authors.forename: Lorna
authors.initials: L
authors.lastname: Spagnol
mesh_terms: D002675:Child, Preschool; D003884:Dermoid Cyst / Q000473:pathology / Q000601:surgery*; D004954:Esthetics; D005142:Eyelid Neoplasms / Q000473:pathology / Q000601:surgery*; D005143:Eyelids / Q000033:anatomy & histology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D013536:Suture Techniques; D016896:Treatment Outcome