# Minimally Invasive Surgery for Giant Epidermoid Cysts of the Head and Neck Region: A Case Series

## TL;DR

This paper presents two rare cases of large epidermoid cysts in the head and neck, treated with minimally invasive techniques to avoid major surgery and preserve quality of life.

## Contribution

The study demonstrates the effectiveness of individualized, minimally invasive approaches for treating giant epidermoid cysts in challenging locations.

## Key findings

- Transoral excision was used for a sublingual cyst to avoid visible scarring.
- Endoscopic marsupialization via a transnasal-transmaxillary approach successfully treated an infratemporal fossa cyst with no recurrence after three years.
- Minimally invasive techniques can be appropriate alternatives to complete excision in selected patients.

## Abstract

Two distinct cases of giant epidermoid cysts in rare head and neck anatomical locations - one in the sublingual space and the other in the infratemporal fossa - are reported, highlighting the variability in presentation, imaging characteristics, and surgical management. Transoral excision of the cyst was selected for case 1 to minimize cosmetic concerns. For case 2, given the benign nature of the lesion and the patient's preference for a less invasive procedure, endoscopic marsupialization via a transnasal-transmaxillary approach was chosen. This method relieved symptoms, minimized surgical risks, and preserved quality of life, with no recurrence noted after three years. These cases underscore the importance of individualized treatment strategies for giant epidermoid cysts. While complete surgical excision remains the gold standard, minimally invasive options such as marsupialization may be appropriate in selected patients, especially when considering factors such as age, comorbidities, symptoms, and cosmetic outcomes.