{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:28:12Z","timestamp":1786649292852,"version":"build-2736575974"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>The purpose of this study was to characterize intradiploic dermoid and epidermoid orbital cysts to determine any differences in clinical, radiographic, or surgical features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review was performed of patients presenting with intradiplopic dermoid or epidermoid cysts. Additionally, a complete review of the literature was performed to identify cases of intradiplopic orbital dermoid and epidermoid cysts. Data collected included age, sex, presenting symptoms, location of intradiplopic cyst, ophthalmic findings, treatment, and follow-up. Clinical features of dermoid versus epidermoid cyst were compared. Additionally, machine-learning algorithms were developed to predict histopathology based on clinical features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There were 55 cases of orbital intradiploic cysts, 49 from literature review and six from our cohort. Approximately 31% had dermoid and 69% had epidermoid histopathology. Average age of patients with dermoid cysts was significantly lesser than that of patients with epidermoid cysts (23 vs. 35 years, respectively;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.048). There was no difference between sex predilection, presenting symptoms, radiographic findings, or surgical treatment of dermoids and epidermoids. The majority of patients (64%) underwent craniotomy for surgical removal. Machine-learning algorithms KStar and Neural Network were able to distinguish dermoid from epidermoid with accuracies of 76.3% and 69%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Orbital intradiploic cysts are more commonly epidermoid in origin. Dermoid cysts presented in younger patients; however, there were no other significant differences in features including ophthalmic or radiographic findings. Despite similar features, machine learning was able to identify dermoid versus epidermoid with good accuracy. Future studies may examine the role of machine learning for clinical guidance as well as new surgical options for intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_52_22","type":"journal-article","created":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T07:18:21Z","timestamp":1654067901000},"page":"2102-2106","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":15,"title":["Differentiating intradiploic orbital dermoid and epidermoid cysts utilizing clinical features and machine learning"],"prefix":"10.4103","volume":"70","author":[{"given":"Andrea A","family":"Tooley","sequence":"first","affiliation":[{"name":"Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashant","family":"Tailor","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann Q","family":"Tran","sequence":"additional","affiliation":[{"name":"Manhattan Ear, Eye, and Throat Hospital, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A","family":"Garrity","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Eckel","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J","family":"Link","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,5,31]]},"reference":[{"key":"R1-20251004","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1080\/09286586.2018.1525412","article-title":"Pediatric periocular dermoid cysts:Incidence, clinical characteristics, and surgical outcomes","volume":"26","author":"Bajric","year":"2019","journal-title":"Ophthalmic Epidemiol"},{"key":"R2-20251004","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1016\/j.ophtha.2020.02.037","article-title":"Presentation and treatment of deep orbital dermoid cysts","volume":"127","author":"Vahdani","year":"2020","journal-title":"Ophthalmology"},{"key":"R3-20251004","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1016\/S0161-6420(91)32058-X","article-title":"Intradiploic epidermoid cysts of the bony orbit","volume":"98","author":"Eijpe","year":"1991","journal-title":"Ophthalmology"},{"key":"R4-20251004","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.clineuro.2004.06.005","article-title":"Intradiploic epidermoid cysts of the skull:A report of four cases","volume":"107","author":"Bikmaz","year":"2005","journal-title":"Clin Neurol Neurosurg"},{"key":"R5-20251004","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1080\/01676830.2018.1449226","article-title":"Intradiploic epidermoid cyst of the orbital roof:A case report","volume":"38","author":"Lee","year":"2019","journal-title":"Orbit"},{"key":"R6-20251004","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/0002-9610(49)90207-X","article-title":"Intradiploic epidermoid tumors (cholesteatoma of the skull)","volume":"78","author":"Adelstein","year":"1949","journal-title":"Am J Surg"},{"key":"R7-20251004","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/0002-9394(75)90087-2","article-title":"Deep orbital dermoid with draining sinus","volume":"79","author":"Pollard","year":"1975","journal-title":"Am J Ophthalmol"},{"key":"R8-20251004","doi-asserted-by":"crossref","first-page":"577","DOI":"10.2176\/nmc.23.577","article-title":"Intradiploic epidermoid tumor of the lateral orbital wall--Case report","volume":"23","author":"Wakai","year":"1983","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"R9-20251004","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1001\/archotol.1987.01860090093028","article-title":"Intradiploic epidermoid cyst of the sphenoid wing","volume":"113","author":"White","year":"1987","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"R10-20251004","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/BF01402183","article-title":"Intradiploic epidermoid cysts of the skull:Report of 10 cases and review of the literature","volume":"102","author":"Ciappetta","year":"1990","journal-title":"Acta Neurochir (Wien)"},{"key":"R11-20251004","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1055\/s-2008-1060565","article-title":"Giant intradiploic epidermoid cyst of greater sphenoid wing causing unilateral proptosis and optic nerve compression","volume":"3","author":"Sargent","year":"1993","journal-title":"Skull Base Surg"},{"key":"R12-20251004","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1007\/BF00596575","article-title":"Intradiploic epidermoid cysts","volume":"38","author":"Arana","year":"1996","journal-title":"Neuroradiology"},{"key":"R13-20251004","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1016\/S0278-2391(98)90622-X","article-title":"Temporal dermoid with intracranial extension:Report of a case","volume":"56","author":"Niederhagen","year":"1998","journal-title":"J Oral Maxillofac Surg"},{"key":"R14-20251004","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1016\/S0009-9260(99)90686-4","article-title":"Computed tomography of orbital dermoids:A 20-year review","volume":"54","author":"Chawda","year":"1999","journal-title":"Clin Radiol"},{"key":"R15-20251004","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/S0161-6420(99)90074-X","article-title":"Primary temporal fossa dermoid cysts. Characterization and surgical management","volume":"106","author":"Meyer","year":"1999","journal-title":"Ophthalmology"},{"key":"R16-20251004","first-page":"913","article-title":"Quiz case 2. Intradiploic epidermoid cyst","volume":"125","author":"Posey","year":"1999","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"R17-20251004","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1001\/archopht.119.5.771","article-title":"Orbital intradiploic giant epidermoid cyst","volume":"119","author":"Blanco","year":"2001","journal-title":"Arch Ophthalmol"},{"key":"R18-20251004","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1016\/S0161-6420(13)31500-0","article-title":"Invasive squamous cell carcinoma arising from asymptomatic choristomatous cysts of the orbit. Two cases and a review of the literature","volume":"100","author":"Holds","year":"1993","journal-title":"Ophthalmology"},{"key":"R19-20251004","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1007\/s007010200057","article-title":"Traumatic rupture into frontal sinus of a frontal intradiploic epidermoid cyst","volume":"144","author":"Schonauer","year":"2002","journal-title":"Acta Neurochir (Wien)"},{"key":"R20-20251004","first-page":"707","article-title":"[Case of enlargement of an intradiploic epidermoid cyst by a head contusion]","volume":"61","author":"Aiyama","year":"2009","journal-title":"Brain Nerve"},{"key":"R21-20251004","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/SMJ.0b013e3181c2a867","article-title":"Primary intradiploic pterional epidermoid cyst","volume":"103","author":"Berti","year":"2010","journal-title":"South Med J"},{"key":"R22-20251004","doi-asserted-by":"crossref","first-page":"114","DOI":"10.3109\/01676830.2010.551799","article-title":"Epidermoid cyst masquerading as dacryocystocele:Case report and review","volume":"30","author":"Lelli","year":"2011","journal-title":"Orbit"},{"key":"R23-20251004","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s10006-010-0232-y","article-title":"Uncommon presentation of an intradiploic orbital epidermoid tumor:Case report","volume":"15","author":"Ormond","year":"2011","journal-title":"Oral Maxillofac Surg"},{"key":"R24-20251004","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1097\/IOP.0b013e31821387ad","article-title":"Intradiploic epidermoid cyst of frontal bone with spontaneous fistulization to eyelid","volume":"28","author":"Akbaba","year":"2012","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"R25-20251004","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1097\/IOP.0b013e31827a7622","article-title":"An analysis of 2,480 space-occupying lesions of the orbit from 1976 to 2011","volume":"29","author":"Bonavolonta","year":"2013","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"R26-20251004","doi-asserted-by":"crossref","first-page":"e128","DOI":"10.1097\/SCS.0b013e3182700a03","article-title":"Posttraumatic intradiploic epidermoid cyst of frontal bone","volume":"24","author":"Samdani","year":"2013","journal-title":"J Craniofac Surg"},{"key":"R27-20251004","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.4103\/0301-4738.146039","article-title":"Unusual case of temporal dermoid cyst presenting as oculomotor nerve palsy","volume":"62","author":"Adulkar","year":"2014","journal-title":"Indian J Ophthalmol"},{"key":"R28-20251004","doi-asserted-by":"crossref","first-page":"e58","DOI":"10.1097\/SCS.0000000000001100","article-title":"Asymptomatic intradiploic epidermoid cyst eroding frontal bone in a patient with craniosynostosis","volume":"26","author":"Yildiz","year":"2015","journal-title":"J Craniofac Surg"},{"key":"R29-20251004","doi-asserted-by":"crossref","first-page":"e135","DOI":"10.1097\/IOP.0000000000000327","article-title":"Intracranial extension of an orbital epidermoid cyst","volume":"32","author":"Burnham","year":"2016","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"R30-20251004","first-page":"167","article-title":"Intradiploic epidermoid tumors of the cranium:Case report with review of the literature","volume":"78","author":"Arko","year":"2017","journal-title":"J Neurol Surg A Cent Eur Neurosurg"},{"key":"R31-20251004","doi-asserted-by":"crossref","first-page":"110","DOI":"10.4103\/2008-322X.200169","article-title":"Deep orbital dermoid cyst bulging into the superior orbital fissure:Clinical presentation and management","volume":"12","author":"Kumar","year":"2017","journal-title":"J Ophthalmic Vis Res"},{"key":"R32-20251004","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.jaapos.2018.04.013","article-title":"Orbital dermoid cyst presenting as chronic osteomyelitis","volume":"22","author":"Mukherjee","year":"2018","journal-title":"J AAPOS"},{"key":"R33-20251004","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.wneu.2018.08.197","article-title":"Dermoid and epidermoid cysts of scalp:Case series of 234 consecutive patients","volume":"120","author":"Prior","year":"2018","journal-title":"World Neurosurg"},{"key":"R34-20251004","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.wneu.2019.03.222","article-title":"Frontotemporal dermal sinus tract with 2 connected intradiploic dermoid cysts:A rare case and review of the literature","volume":"127","author":"Barkley","year":"2019","journal-title":"World Neurosurg"},{"key":"R35-20251004","doi-asserted-by":"crossref","first-page":"e158","DOI":"10.1097\/IOP.0000000000001358","article-title":"Orbital extension of a frontal bone intradiploic epidermoid cyst","volume":"35","author":"Diniz","year":"2019","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"R36-20251004","doi-asserted-by":"crossref","first-page":"28","DOI":"10.5414\/NP301135","article-title":"Primary intradiploic epidermoid cyst:A case report with literature review","volume":"38","author":"Ma","year":"2019","journal-title":"Clin Neuropathol"},{"key":"R37-20251004","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1080\/01676830.2018.1457060","article-title":"A giant dermoid cyst of the orbit","volume":"38","author":"Mukherjee","year":"2019","journal-title":"Orbit"},{"key":"R38-20251004","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1080\/01676830.2019.1631357","article-title":"The spectrum of orbital dermoid cysts and their surgical management","volume":"39","author":"Bajric","year":"2020","journal-title":"Orbit"},{"key":"R39-20251004","doi-asserted-by":"crossref","first-page":"e103","DOI":"10.1097\/IOP.0000000000001616","article-title":"Pilosebaceous malignant transformation of dermoid cyst in the orbit","volume":"36","author":"Concepcion-Torio","year":"2020","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"R40-20251004","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.jaapos.2020.10.002","article-title":"Sphenofrontal intradiploic dermoid cyst with cutaneous dermal sinus tract","volume":"25","author":"Hatcher","year":"2021","journal-title":"J AAPOS"},{"key":"R41-20251004","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.jcjo.2019.08.005","article-title":"Orbital and periorbital dermoid\/epidermoid cyst:A series of 280 cases and a brief review","volume":"55","author":"Pushker","year":"2020","journal-title":"Can J Ophthalmol"},{"key":"R42-20251004","doi-asserted-by":"crossref","first-page":"106381","DOI":"10.1016\/j.clineuro.2020.106381","article-title":"Epidermoid cyst of the anterior clinoid process:Report of a unique finding and literature review of the middle cranial fossa locations","volume":"200","author":"D'Andrea","year":"2021","journal-title":"Clin Neurol Neurosurg"},{"key":"R43-20251004","doi-asserted-by":"crossref","first-page":"e102","DOI":"10.1097\/SCS.0000000000006762","article-title":"Posttraumatic giant intradiploic epidermoid cyst of orbital roof","volume":"32","author":"Zhang","year":"2021","journal-title":"J Craniofac Surg"},{"key":"R44-20251004","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1097\/IOP.0b013e318247ec8b","article-title":"Re:\u201cIntradioploic epidermoid cyst of frontal bone with spontaneous fistulization to eyelid\u201c","volume":"28","author":"Karaconji","year":"2012","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"R45-20251004","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1177\/000348947908800412","article-title":"Cholesteatoma of the frontal and ethmoid areas","volume":"88","author":"Campanella","year":"1979","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"R46-20251004","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1136\/bjo.74.7.445","article-title":"Frontal bone epidermoid--A rare cause of proptosis","volume":"74","author":"Chowdury","year":"1990","journal-title":"Br J Ophthalmol"},{"key":"R47-20251004","first-page":"218","article-title":"Dermoids and epidermoids of the orbit","volume":"46","author":"Pfeiffer","year":"1948","journal-title":"Trans Am Ophthalmol Soc"},{"key":"R48-20251004","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1001\/archopht.1982.01030030614015","article-title":"'Cholesteatoma'of the orbit","volume":"100","author":"Parke","year":"1982","journal-title":"Arch Ophthalmol"},{"key":"R49-20251004","first-page":"22","article-title":"Intradiploic epidermoid cysts in adults. CT contribution to diagnosis in 6 new cases","volume":"13","author":"Guiard","year":"1986","journal-title":"J Neuroradiol"},{"key":"R50-20251004","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/01.iop.0000217569.68190.7a","article-title":"Giant epidermoid cyst as an unusual presentation of hypoglobus and ptosis","volume":"22","author":"Iranmanesh","year":"2006","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"R51-20251004","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.1016\/j.joms.2005.08.003","article-title":"Intraorbital epidermoid tumors:A case report and a review of the literature","volume":"63","author":"Keene","year":"2005","journal-title":"J Oral Maxillofac Surg"},{"key":"R52-20251004","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/00002341-199712000-00007","article-title":"Orbital dermoid cysts:Clinicopathologic correlations, classification, and management. The 1997 Josephine E","volume":"13","author":"Shields","year":"1997","journal-title":"Schueler lecture. Ophthalmic Plast Reconstr Surg"},{"key":"R53-20251004","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1136\/bjo.68.9.642","article-title":"Orbital dermoids:Clinical presentation and management","volume":"68","author":"Sherman","year":"1984","journal-title":"Br J Ophthalmol"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijo.IJO_52_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:52:02Z","timestamp":1786647122000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijo.IJO_52_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,31]]},"references-count":53,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_52_22","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,31]]},"assertion":[{"value":"2022-01-07","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-24","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}