Can Frontal Eminences Be Reduced Endoscopically?
Q: Dr. Eppley, Hello! My frontal bumps are very pronounced and I want to get rid of them, but my hair is not thick and I’m balding, so I can’t do surgery with a coronal or hairline incisions, a big scar is not acceptable for me.Can I reduce the frontal eminences endoscopically? One doctor said that endoscopic removal is dangerous, why? If an endoscopic osteoma can be removed, then why can’t the eminences be removed as well?
A: An endoscopic technique is not going to work for frontal eminence reductions because such reductions require power equipment which can not pass through a small incision or work around a curved surface. Frontal eminences are broad based bone elevations of the outer cranial surface.
Conversely endoscopic removal of osteoma uses an osteotome which is effective for them because they are bone growths just above the outer cranial surface that is attached to it by a narrow base. (like a mushroom) Thus they are rather easily separated from the surface by the osteotome.
The one intermediate technique that I have found useful in cases like yours is the rasp technique. With incisions as small as that used for endoscopic surgery a large toothed rasp is inserted which can aggressively remove bone manually. It is a blind technique where the reduction is ultimately guided by eternal appearance and feel.
Dr. Barry Eppley