PROBLEM

Bony lumps on forehead; heavy masculine orbital rim

PROCEDURE

Frontal bone ostectomy; Removal of excess bone

PRE-OPERATIVE EVALUATION

Lumps. Any bony lumps on the forhead are usually osteoid osteomas which are benign growths of bone. A preoperative CT scan or plain x-ray will aid in the diagnosis.

Heavy, masculine brow. This is usually congenital but in the area between the eyebrows may indicate an excessive growth of the frontal sinus. A CT scan or plain x-ray is helpful in ascertaining extent.

TECHNIQUES

Surgical removal depends upon where the lump is located and the extent of the heavy orbital rim. For simple isolated osteoids, a simple, short incision over it or coming from the hairline works well. For heavy brows in people with normal hairlines, I approach from the scalp. If the hair is sparse, and the amount limited, I make a small incision under the eyelid. We use a small 4mm burr on an extension. This sands the bone down safely. There is a limit - one can't burr into the sinus nor into the cortex or centerof the bone as this will leave contour problems and/or infections.

All procedures are performed in our clinic.the procedure takes 30 minutes to 1 hour and 15 minutes.

ANESTHESIA TYPE

IV sedation or local for small lumps.

RECOVERY

1-3 days.