Primary temporal fossa dermoid cysts - Characterization and surgical management

Objective: To detail the characteristics and management of rarely reported and incompletely described dermoid cysts originating in the temporal fossa, Design: Retrospective case series. Participants: Five patients ranging from 2 to 38 years of age with a mass i n the temporal region (posterior to the lateral orbital rim) participated. Intervention: Computed tomography (CT) and excisional biopsy were performed . Main Outcome Measures: Clinical and CT characteristics and surgical outcome s were measured. Results: Computed tomography showed cystic lesions, originating from the re gion anterior to the confluence of the greater wing of the sphenoid, fronta l, and zygomatic bones. Displacement of the anteriormost portion of the tem poralis muscle was common. Three cysts were isolated to the temporalis foss a, while two showed more extensive bony erosion and extension into the cran ial and orbit cavities, At surgical excision, gross rupture of the cysts wa s noted in two cases, and two were completely liquefied, Histopathology sho wed variable inflammation surrounding all of the dermoid cysts. All patient s did well after surgery. Conclusions: Dermoid cysts may infrequently occur "primarily" in the tempor al fossa, Bone involvement and anterior temporalis muscle displacement are common. An origin from the area anterior to the confluence of the greater w ing of the sphenoid, frontal, and zygomatic bones is seen. A coronal approa ch facilitates wide exposure and excision, When dural extension is suggeste d on CT, neurosurgical assistance may be required.