The Exoscope in the Excision of Medial Orbital Dermoid Cysts

Summary: Orbital dermoid cysts are the most common orbital tumors in childhood. Although typically superficial and lateral, uncommon medial lesions may pose surgical challenges due to proximity to critical structures. The exoscope offers high-definition, 3-dimensional visualization and ergonomic advantages to surgeons in these complex anatomical cases. A 4-year-old patient presented with progressive globe displacement and fullness of the right upper lid. Imaging revealed a 1.7 × 1.3 cm circumscribed lesion in the superior medial orbit, displacing the globe and abutting the superior rectus muscle. The patient underwent orbitotomy with the Modus V (Synaptive Medical Inc.) exoscope for visualization. Postoperatively, near-normal globe position was achieved with preserved vision, resolution of eyelid asymmetry, and no complications. Medial orbital dermoid cysts present unique surgical challenges. The exoscope facilitated safe, precise excision in a confined anatomical space, offering both technical and ergonomic benefits.