Lesser wing of sphenoid bone dermoid cyst resection: a pediatric transorbital neuroendoscopic approach

A 3-year-old male presented with a history of a nasal dermoid cyst with intracranial extension as well as a concomitant isolated intracranial dermoid cyst of the middle cranial fossa. Initially, at 2 years of age, he underwent successful transnasal endoscopic resection of an anterior skull base dermoid cyst. He then presented for a staged dermoid cyst resection of the right sphenoid bone at the lesser wing because of interval growth between imaging studies. A right-sided transorbital neuroendoscopic approach (TONES) was utilized for lesion resection. A gross-total resection was achieved, with no complications. Excellent neurological and cosmetic outcome was achieved. The video can be found here: https://stream.cadmore.media/r10.3171/2025.1.FOCVID24157.