Excision of medial dermoid cyst
This is Richard Allen at the University of Iowa. This video demonstrates excision of a medial dermoid cyst using a lid crease incision.
A 15 blade is used to make an incision along the lid crease which was previously marked.
A monopolar cautery is then used to dissect through the orbicularis muscle to the orbital septum.
The cyst is palpated and dissection within the orbital septum is performed with Westcott scissors in order to identify the cyst.
A Freer periosteal elevator is used to dissect along the surface of the cyst.
Additional gentle blunt dissection can be performed with a cotton tip applicator.
A cryo probe is then used to engage the surface of the cyst in order to retract it and prevent rupture with sharp forceps.
Additional dissection is then performed with Westcott scissors.
Dissection is carried out additionally with the Freer periosteal elevator until attachment to the bone is identified.
The periosteal elevator can be used to incise the periosteum if needed to release the cyst from the attachments.
Excision is completed with Westcott scissors, being careful not to rupture the cyst.
The specimen is sent to the pathologist after removal.
After hemostasis is assured, the incision can be closed with interrupted 5-0 fast absorbing sutures.
Antibiotic ointment is placed over the repair and the patient returns in approximately one week.