Botulinum Toxin and Burn Induces Contracture

609 throughout the body. These cysts on the face and neck are frequently found in children. New and Erich classified dermoid cysts on the basis of their location. The most frequently involved area is the periorbital area, followed by the nasal dorsum, submental area, and the suprasternal area [1]. Periorbital dermoid cysts are congenital tumors that appear along the naso-optic groove between the maxillary and the mandibular processes during embryonic closure (i.e., the frontonasal and frontozygomatic suture line). Dermoid cysts contain cells of a dermal or an epidermal origin. When a cyst ruptures because of trauma or infection, keratin can cause inflammation and a granulomatous reaction. Further, periorbital dermoid cysts often have intracranial or intraorbital effects. These effects progress slowly, and when presented later in life, they may cause proptosis, strabismus, globe dystopia, visual field defects, dehiscence of the frontozygomatic suture, and swelling of the temporalis fossa. Such an extension of lateral brow dermoid cysts is a rare but distinct possibility. Therefore, imaging studies such as CT and magnetic resonance imaging are necessary before surgical excision. The treatment for a periorbital dermoid cyst is surgical excision. There is no consensus on the appropriate timing of the excision. Because dermoid cysts grow with the child and there is a chance of rupture, excision should be performed [2]. In order to decide on the timing of the excision, the size of a dermoid cyst, presence of symptoms, and parents' needs should be considered. Thus far, superficial dermoid cysts on the lateral orbit, as in our case, have been excised through direct incision, upper eyelid crease incision, and an endoscope-assisted approach. If we consider only aesthetics, the endoscopic technique is preferable. However, c onsidering cost effectiveness and hair loss, upper eyelid crease incision is a better approach. To remove a cyst completely and to avoid rupture, a meticulous dissection technique is required as it prevents postoperative complications such as inflammation caused by dermoid components. However, there is always a shallow depression on the bone. Sometimes, this depression is sufficiently large to cause a depressive contour deformity. To prevent such a postoperative depression, Lee and Persing proposed a method of reconstruction using preaponeurotic orbital fat flaps as fillers [3]. Bilateral facial masses are not commonly encountered. If there are symmetrically bilateral masses on someone's face, people may consider them natural and not abnormal and clinicians may also ignore them. Further, the lateral end of …