Interventional radiologists at Nationwide Children's Hospital are unique not only because they pioneered the development of minimally-invasive dermoid cyst ablation, but they have also performed more dermoid cyst ablation procedures than any center in the world. Patients travel from across the country to Nationwide Children's Hospital for dermoid cyst treatment.
If you, or your child, have been told you need a dermoid cyst ablation and want to pursue minimally invasive treatment, call our Interventional Coordinator at (614) 722-2375 to set up a consultation with an Interventional Radiologist. You may also request an appointment using our online form.
In the past, the only treatment option for a dermoid cyst was surgical removal of the cyst. If the dermoid cyst is in the bone, surgery includes making an incision, opening access to the bone, and drilling or scraping the dermoid cyst cells out of the bony cavity. In locations like the forehead and skull, surgical incisions can be wide (right to left in the front of the scalp, in order for the forehead skin to be pulled forward to allow access to the dermoid cyst for removal).
These therapeutic challenges, particularly voiced by neurosurgeons at Nationwide Children's Hospital, led to the development of minimally-invasive diagnostic and treatment solutions (drainage and ablation) by our radiology team. There are no treatments using medication for dermoid cysts. Dermoid cysts must either be removed through surgical incisions or ablated (killed) through minimally-invasive drainage and ablation.
Dermoid cyst ablation is a minimally-invasive procedure in which the dermoid cyst is entered with a small needle and plastic sleeve through which the dermoid cyst is killed (ablated) within the body. The body’s own "cleanup" mechanisms then remove the dead dermoid cyst cells during healing. The result leaves a scar the size of a freckle.
Dermoid cyst ablation begins with drainage of the cyst contents with a technique that "thins" the oily contents with a medical detergent and allows drainage of the cyst contents. After "cleaning" and "removal" of the cyst contents, the collapsed lining membranes (skin cells that line the cyst and produce the cyst contents) that surround the cyst are ablated (killed) with a precise needle technique known as "coblation." Using precision ultrasound guidance, the coblation needle tip is placed within the collapsed dermoid cyst and the coblation energy (plasma cloud) destroys the cells of the dermoid cyst.
Dermoid cysts ablation is performed in less than 1 hour.
The primary risk during dermoid cyst ablation is injury to the overlying skin. Skin is protected from injury by injection of sterile fluid that "lifts" the skin away from the coblation energy cloud, providing precise ablation of the dermoid cyst capsule without adjacent skin injury.
Once the dermoid cyst ablation procedure is completed, the body removes the dead dermoid cyst cells and heals the treatment site. If bone is involved with the dermoid cyst, the bone containing the ablated dermoid cyst heals and new bone forms to fill in the previous defect caused by the dermoid cyst. New bone healing after dermoid cyst ablation may be seen in 2-3 months.
Patients who have undergone dermoid cyst ablation may shower immediately following treatment. They are instructed to refrain from submerging the treated site in a bath for 5 days to allow full healing of the small skin opening used for access to the dermoid cyst.
Aside from keeping the treatment site clean, there are no activity restrictions following dermoid cyst ablation.
Dermoid cyst ablation is successful in 95% of patients with one treatment session. A second treatment session may be required (5% of patients) if injury to the dermoid cyst occurred prior to treatment resulting in rupture of the dermoid cyst wall (prior to treatment).
Results observed in our patients since 2006 have been excellent. All treated patients reported no postoperative pain, infection, swelling, or evidence of inflammatory response. Once ablated and healed, the treated site looks and feels normal.
Dermoid cysts left untreated will continue to enlarge. If injured and the cyst wall is ruptured, the leaking cyst contents irritate the surrounding tissues causing pain and swelling. Untreated dermoid cysts may occasionally become infected, requiring treatment with antibiotics and more urgent surgical removal or minimally invasive ablation.