The use of a subcutaneous fat hinge flap for reconstruction in an adult patient with a midline nasal dermoid sinus cyst

Abstract

Congenital nasal midline lesions are rare and typically occur in childhood. These lesions occur due to a failure in separation of neuroectodermal or ectodermal tissues. Nasal dermoid cysts are cystic structures of ectodermal origin and are typically found in childhood with few reported adult cases. In this report, we present a rare case of a 31-year-old female who presented with recurrent infections of the nasal radix and a hypertrophic scar in the same location. The dermoid cyst, located at the midline of the forehead, the nasal radix, and the nasal tip, was surgically removed, leaving a defect of the radix and a significant change in the facial profile of the patient. The defect was repaired with a novel technique using a subcutaneous fat hinge flap from the nasal glabella that was rotated 180° to restore normal facial profile. A favorable cosmetic outcome was achieved, and the patient was followed for 6 months with no recurrence.