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ARTICLE TYPE : RESEARCH ARTICLE

Published on :   26 Oct 2026, Volume - 2
Journal Title :   WebLog Journal of Head and Neck Surgery | WebLog J Head Neck Surg | WJHNS
Source URL:   weblog icon https://weblogoa.com/articles/wjhns.2026.j2602
Permanent Identifier (DOI) :   doi icon https://doi.org/10.5281/zenodo.23883005

Endoscopic Versus Upper Eyelid Approaches for Excision of Pediatric External Angular Dermoid Cysts: A Prospective Cohort Study

Ahmed Gaber Hassanein 1 *
Islam A. Amer 1
Pankaj Kukreja 2
Kamal AM. Hassanein 1
Mahmoud Abd Elghany 1
Tarek Elsayed Ftohy 1
Mahmoud Sobhi Allam 1
1Maxillofacial Head & Neck Surgery Unit, General Surgery Department, Faculty of Medicine, Sohag University, Sohag, Egypt
2Department of Dental and Biomedical Sciences, Faculty of Dentistry, Albaha University, Albaha, Saudi Arabia

Abstract

Background: The treatment of external angular dermoid cysts is surgical excision through the direct surgical approach, the upper eyelid crease approach, or the endoscopic approach which uses hidden scalp incision to avoid facial scar. This study aimed to study and compare the surgical and cosmetic outcomes between endoscopic approach and upper eyelid crease approach and to determine which is better for such cases.

Methods: A prospective cohort study included 40 selected children with external angular dermoid cysts. Patients were randomly allocated into two groups; Group 1: treated by endoscopic approach and Group 2: treated by upper eyelid crease approach. Operative time, intraoperative complications, hospital stay and postoperative complications were evaluated. Cosmetic outcomes were assessed by both patients’ parents and surgeons. Data were analyzed to determine which approach is better.

Results: the operative time and hospital stay were higher in group-1, with a highly significant result (p = 0.0001). Postoperative complications were also significantly higher in group-1 (p = 0.04). Cosmetic evaluation by surgeons was better in group-1, though not statistically significant (p-value 0.09). Cosmetic evaluation by parents was significantly better in group-1 (p-value 0.04).

Conclusions: The upper eyelid crease approach is much better than the endoscopic approach. It is a versatile, technically simple, cost-efficient approach that allowed excision of external angular dermoid cysts some distance away from the incision with low complication rates and high esthetic success rates. Although endoscopic approach has better cosmetic outcomes, we recommend upper eyelid crease approach for external angular dermoid cyst excision.

Keywords: External Angular Dermoid Cysts; Endoscopic Approach; Upper Eyelid Crease Approach; Cosmetic Outcome

Citation

Hassanein AG, Amer IA, Kukreja P, Hassanein KAM, Abd Elghany M, Ftohy TE, et al. Crease Approaches for Excision of Pediatric External Angular Dermoid Cysts: A Prospective Cohort Study. WebLog J Head Neck Surg. wjhns.2026.j2602. https://doi.org/10.5281/zenodo.23883005
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