Forehead Osteoma Removal
Q: Dr. Eppley, I would like to ask about forehead osteoma removal. I have it from about 8 years. It is very good visible in direct light. As an attachment I have some photos of my forehead. I also have attached x-rays taken a few years ago.I see it on your website that I will need a CT scan anyway.
I have few questions:
1) What is the procedure, step by step, with a forehead osteoma of this size?
2) Will it be done under local or general anesthesia?
3) During the operation I will breathe by myself or with the respirator? Or you will find it after CT scan and with the knowledge if the oeteoma is only on the surface of skull or it is also inside the skull?
4) Can you remove the osteoma with endoscopic method with the drill? The endoscopic method would be the best for me because it leaves no visible scar and it is less invasive.
5) Can we consult by Skype?
6) Before the surgery I will need some relaxing medicines.
A: Thank you for your inquiry and sending your pictures. Your forehead osteoma is very evident. The very pertinent question is whether this is an osteoma that is an outgrowth of the outer cranial table or whether this is an osteoid osteoma that invades the full thickness of the cranial bone. This distinction is critical as their treatment differs radically. I will assume for now that you have the more benign and common outer table osteoma. In answer to your questions:
1) Endoscopic or hairline incisional approach for removal.
2) Full anesthesia
3) A CT scan must be done to make the proper preoperative diagnosis.
4) An endoscopic approach can not use a drill or any other power equipment, it uses an osteotome or chisel.
5) A virtual consultation is done before surgery.
6) Sedative medication can be provided.
Dr. Barry Eppley