Osteomas are benign bone tumors commonly found in the skull, especially on the frontal bone, usually in the mid-to-upper forehead region. They grow slowly over the years until they become visible as a lump or bump underneath the skin.
Osteomas are asymptomatic in most people but may occasionally cause some discomfort. Generally, individuals with a frontal osteoma seek treatment for cosmetic reasons. In such cases, the patient will seek a facial plastic surgeon to remove the growth.
Surgical treatment of frontal osteoma: direct vs. endoscopic
Surgeons have two options for removing an osteoma. One option is to make a skin incision directly above the tumor and remove it under direct vision. This is a very straightforward procedure that can be done with local anesthesia and mild intravenous sedation. Its main limitation is that it can leave a visible scar in the area of the osteoma. Since most patients who choose to have the tumor removed do so for cosmetic reasons, a therapeutic alternative should be considered.
The alternative is an endoscopic approach, which removes the osteoma through an incision behind the hairline. Instead of direct visualization and excision, a camera is employed to identify and remove the bone growth. This technique offers the same result as the direct approach- that is, complete removal of the tumor, but leaves an inconspicuous scar that remains hidden in the hair-bearing scalp.
Granted, this procedure requires more sophisticated equipment and entails a higher cost, but the cosmetic results usually override the inconvenience. Some patients opt to have their osteoma removed when undergoing an already-scheduled elective facial plastic surgery such as an endoscopic brow lift.
Recovery after endoscopic removal of frontal osteoma
After endoscopic removal of frontal osteoma, mild bruising, and swelling, especially if accompanied by other procedures, should be expected. Patients should avoid exercising and lifting heavy objects for one week after surgery. Fortunately, the recovery is not painful, and results can be seen as soon as the patient leaves the operation room.
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