Minimal-Scar Segmental Extraction of Lipomas

A Method of Transoral Finger Dissection for a Giant Epiglottic Lipoma

“…Because the liquid contents did not drain from the epiglottic tumor in the current case, it was suspected to be solid. Furthermore, CT or magnetic resonance images can be useful to differentiate a solid tumor from a lipoma, pleomorphic adenoma, neuroma, hemangioma, chondroma, fibroma, or malignant neoplasm of liposarcoma [9, 10]. The current case was preoperatively suspected to be a lipoma because of its CT images (Figure 2).…”

“…Lipomas that occur in the trunk and proximal extremities are commonly extirpated by low-invasive methods [9, 10]. The conventionally performed method for subcutaneous lipomas is to use the surgeon's index finger to separate it from surrounding tissues and dissect it en bloc [10].…”

“…In previous reports, giant epiglottic lipomas have been dissected by macroscopic surgery via external cervical incisions (e.g., thyrotomy, transhyoid or lateral pharyngotomy, or laryngofissure) [1, 3, 5] or piecemeal excisions [9, 11]. A piecemeal excision is inappropriate because remnants or dissemination of the lipoma can cause postoperative recurrence [9, 11, 12]. In the current case, the method of transoral finger dissection satisfied the conditions that the giant epiglottic lipoma was dissected en bloc in a low-invasive manner.…”

“…In the current case, the method of transoral finger dissection satisfied the conditions that the giant epiglottic lipoma was dissected en bloc in a low-invasive manner. In addition, surgical manipulations with the surgeon's finger allowed tactual evaluation of the entire structure of the lipoma, particularly deep within the surgical field, and avoided excessive damage to neurovascular structures and the epiglottic cartilage [9, 10]. Although it was invasive, the tracheotomy was indispensable in the current case because of the risk of blockage of the supraglottic airway both intra- and postoperatively [4].…”