Stealth Surgery for Dermoid cyst removal in the Head and Neck

STEALTH SURGERY for Dermoid cyst removal in head and neck


Benign head and neck lesions are traditionally removed through an overlying incision. The resultant scar can be aesthetically displeasing.[1]

The term dermoid cyst does not appear to be restricted to a single kind of lesion nor is it used in only a single medical discipline, can be found in the vocabulary of dermatologists, general pathologists, gynecologists, neurosurgeons, or pediatricians. For eg, gynecologists and general pathologists might say that a dermoid cyst is a cystic tumor of the ovary. In contrast, neurosurgeons miht deal with a intracranial congenital cyst. We, Pediatric surgeons, deal with Subcutaneous congenital Dermoid cysts, and deal with it using Day Care Subcutaneous endoscopic surgery.

Dermoid cysts is quite a common clinical diagnosis in children, usually on the face near the eyebrow, on the scalp or on the chest over the collarbone. It can be months or years before it becomes noticeable because the cysts grow slowly and are usually painless. They aren’t harmful to your child’s health unless they get infected. If they become infected, the infection must be treated and the cyst should be removed. It is easier to remove cysts and prevent scars and prevent recurrence if the cyst is removed before it gets infected. Dermoid cyst treatment  is surgery to remove the cyst. Surgeons remove dermoid cysts to prevent infection or because you or your child doesn’t like how it looks.

Subcutaneous swellings of the scalp, forehead and neck are commonly managed by an incision on the skin within the area of the swelling (and along skin creases to hide the incision scar). No matter how fine surgical skills are, scarring is inevitable and becomes a cosmetically matter of concern for patients and parents (particularly scars over exposed parts of the body, such as face and neck) [3, 4]. These concerns can be resolved by shifting the site of incision from an exposed location to a hidden area of the body, such as behind hairline for scalp swellings and axilla for neck swellings. This approach is also known as stealth surgery, as they allow us to perform relatively invasive procedures without leaving any obvious scar of an operation. [2]

Advantages of Stealth excision over conventional open excision are as follows: 1) a small hidden incision 2)prevents scarring in the head and neck region which are prone for keloid formation 2) Avoiding injury to important structures by endoscopic assisted magnified view and 3) No disfigurement 4)shorter hospital stay 5) better wound healing.[5]




  1. Dutta S1Slater BButler MAlbanese CT J Pediatr Surg.2008 Nov;43(11):2070-4

“Stealth surgery”: transaxillary subcutaneous endoscopic excision of benign neck lesions.

  1. Rahul Kumar Gupta 1,*, Abhaya Gupta 1, Paras Kothari 1, Krushna Kumar Kesan 1, Kedar Mudkhedkar

J Minim Invasive Surg Sci. 2014 February; 3(1):e11389.Endoscopic Excision of Angular Dermoid in a Pediatric Patient: A Case Report

  1. Tebble NJ, Adams R, Thomas DW, Price P. Br J Oral Maxillofac Surg. 2006;44(6):520–5. Anxiety and self-consciousness in patients with facial lacerations one week and six months later.
  2. Tebble NJ, Thomas DW, Price P. Anxiety and self-consciousness in patients with minor facial lacerations. J Adv Nurs. 2004;47(4):417–26.
  3. Guerrissi JO. J Craniofac Surg. 2004;15(4):618–22.Endoscopic excision of frontozygomatic dermoid cysts.

Minimising scars in children

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