Dermoid Cyst Treatment & Management

Updated: Apr 16, 2019
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Surgical Care

Surgical excision is the treatment of choice in any localization. Surgically remove dermoid cysts. The average age at the time of surgery can vary widely; in one retrospective study of 159 patients, it ranged from age 1 month to 63 years. [42]

In some patients, surgery should be performed even more carefully than usual because the fatty content of the cyst may spread to the surrounding tissues or anatomic structures, especially if the cyst is infected with bacteria. The spread of these contents can cause foreign body reactions and severe complications.

Minimally invasive surgical techniques have been successful in removing dermoid cysts from difficult locations, such as those on the tongue or the floor of the mouth. Intralingual dermoid cysts lead to lingual motility defects and speech problems. These cysts should be surgically removed to restore normal lingual function and to correct speech problems.

Intracranial, intramedullary, and ovarian dermoid cysts are difficult to treat. Sophisticated neurosurgical or gynecologic surgical techniques are often needed to remove the dermoid cyst and prevent possible complications. High-definition fiber tracking guidance may be beneficial in the resection of an intraparenchymal dermoid cyst by means of a minimally invasive endoscopic port. [43]

In some patients with dermoid cysts on the forehead and brow, successful excision with endoscopy-assisted surgery have been described. [44] In the reported cases, no complications (eg, paresthesia or numbness on the scalp) occurred. The absence of visible scarring is an additional advantage of endoscopy-assisted surgery.

Angular dermoid cyst excision using an eyelid crease approach may yield excellent cosmesis. [45] External angular dermoid cysts can be excised using a minimally invasive subcutaneoscopic technique that involves placing incisions above the hairline to avoid scarring on the face. [46]

Frontozygomatic removal through a blepharoplasty incision has been advocated for frontozygomatic dermoid cysts. [47]