Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Mar;17(1):39-42.
doi: 10.7181/acfs.2016.17.1.39. Epub 2016 Mar 21.

Forehead Osteoma Excision by Anterior Hairline Incision with Subcutaneous Dissection

Jun Sik Kim  1 , Jeong Hwan Lee  1 , Nam Gyun Kim  1 , Kyung Suk Lee  1
Affiliations

Forehead Osteoma Excision by Anterior Hairline Incision with Subcutaneous Dissection

Jun Sik Kim et al. Arch Craniofac Surg. 2016 Mar.

Abstract

Forehead osteomas are benign but can pose aesthetic and functional problems. These osteomas are resected via bicoronal or endoscopic approach. However, large osteomas cannot be removed via endoscopic approach, and bicoronal approach can result in damage to the supraorbital nerve with resultant numbness in the forehead. We present a new approach to resection of forehead osteomas, with access provided by an anterior hairline incision and subcutaneous dissection. Three patients underwent resection of the forehead osteoma through an anterior hairline incision. The dissection was carried in the subcutaneous plane, and the frontalis muscle and periosteum were divided parallel to the course of supraorbital nerve. The resulting bony defect was re-contoured using Medpor®. All three patients recovered without any postoperative infection or complication and symptoms. Scalp sensory was preserved. Aesthetic outcomes were satisfactory. Patients remain free of recurrence for 12 months of follow up. The anterior hair line approach with subcutaneous dissection is an effective method for removal of forehead osteoma, since it offers broad visualization and hides the scar in the hairline. In addition, the dissection in the subcutaneous plane avoids inadvertent injury to the deep nerve branches and helps to maintains scalp sensation.

Keywords: Dissection; Forehead; Osteoma.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Case 1. Preoperative photograph and computed tomography (CT) scan of a 30-year-old female with a lager right-sided forehead osteoma (A). Postoperative photograph and CT scan at 3-months show a well healing wound that is easily hidden in the hairline and improved contour of the forehead (B).
Fig. 2
Fig. 2. (A) Incision lines for bicoronal incision and anterior hairline incision. (B) The dissection area. The forehead is elevated in the subcutaneous plane. Because the resulting flap is thin and pliable, the supraorbital rim area can be accessed through a much smaller incision.
Fig. 3
Fig. 3. Case 1. (A) Intraoperative view of subcutaneous dissection. (B) The frontalis muscle and periosteum is incised parallel to the course of supraorbital nerve.
See this image and copyright information in PMC

References

    1. Jung ES, Pyon JK, Mun GH, Oh KS. Endoscopic excision of forehead masses. J Korean Cleft Palate-Craniofac Assoc. 2004;5:141–146.
    1. Steele MH, Suskind DL, Moses M, Kluka E, Liu DC. Orbitofacial masses in children: an endoscopic approach. Arch Otolaryngol Head Neck Surg. 2002;128:409–413. - PubMed
    1. Lee HJ, Shin MS, Park BY, Lim SY, Pyon JK, Bang SI, et al. Multiple osteomas in the skull vault: case report. J Korean Soc Plast Reconstr Surg. 2011;38:512–515.
    1. Haddad FS, Haddad GF, Zaatari G. Cranial osteomas: their classification and management: report on a giant osteoma and review of the literature. Surg Neurol. 1997;48:143–147. - PubMed
    1. Savic DL, Djeric DR. Indications for the surgical treatment of osteomas of the frontal and ethmoid sinuses. Clin Otolaryngol Allied Sci. 1990;15:397–404. - PubMed

LinkOut - more resources