Nasal Dermoid Cyst Research Articles

Intranasal dermoid cyst without external sinus tract or swelling in an adult cocker spaniel

An adult female cocker spaniel presented with acute-onset sneezing. Advanced imaging of the nasal cavity revealed a mass lesion with erosion of the normal bony structures. Cytology and histopathology revealed...

Congenital Midline Nasal Mass: Four Cases with Review of Literature

Introduction
 Congenital midline nasal masses include nasal dermoids, gliomas, encephaloceles. Although rare, these disorders are clinically important because of their potential for connection to the central nervous system. Preoperative knowledge of an intracranial connection is a necessity to allow for neurosurgical consultation and possible planning for craniotomy. This study discusses the clinical presentation of congenital midline nasal mass and the role of imaging modalities like CT scan and MRI in diagnosis and the surgical management.
 Materials and Methods
 This prospective study is carried from March 2014 to March 2016, during which 4 cases presented to the Otorhinolaryngology department. Pre-operative evaluation of the patients included endoscopic evaluation along with haematological investigations, CT Scan and MRI. The masses were removed with nasal endoscopic sinus surgery or by external approaches and neurosurgical intervention.
 Result
 The age of the patients ranged from 3 years to 25 years. Three of them were male and one female. There was one case of nasoethmoidal encephalocele and the other three were dermoids (intranasal dermoid cyst, nasal dermoid cyst and nasal dermoid sinus cyst).
 Conclusion
 Congenital midline nasal masses are rare. These disorders are clinically important because of their intracranial connection which require proper evaluation with radiological imaging like CT scan and/or MRI before FNAC and any surgical intervention.

Congenital Midline Nasal Anomalies

Congenital midline nasal anomalies are rare, with a prevalence of 1 in 20,000 to 40,000 births and with 5% to 7% of them being nasal glioma. Differential diagnoses of nasal anomalies include nasal dermoid cysts, gliomas, encephaloceles, nasal polyps, and some other rare anomalies. Due to current medical technological advancements, most of these anomalies are easily correctable, though delaying management may lead to fatal effects. This report describes two cases–one of nasal glioma and one of nevus lipomatosus cutaneous superficialis–that presented as respiratory distress in a newborn. Approximately 10 to 20 cases of these two conditions have been described; notably, this is the second documented case of nevus lipomatosus cutaneous superficialis with nasal presentation.

Sparing a Craniotomy: The Role of Intraoperative Methylene Blue in Management of Midline Dermoid Cysts.

Midline nasal dermoid cysts are rare congenital anomalies that extend intracranially in approximately 10 percent of cases. Cysts with intracranial extension require a craniotomy to avoid long-term complications, including meningitis, abscesses, and cavernous sinus thrombosis. Current guidelines recommend preoperative imaging with either magnetic resonance imaging or computed tomography to determine appropriate management. Patients who underwent excision of a midline nasal dermoid cyst between January 1995 and September 2016 were identified using Current Procedural Terminology codes. In cases with equivocal imaging findings or uncertain stalk extent during surgical dissection, methylene blue was used intraoperatively. Demographics, preoperative imaging findings, intraoperative dye findings, surgical approach, and complications were collected. A total of 66 midline dermoid cyst excisions were identified; 17 (25.8 percent) had intracranial extension requiring craniotomy. Preoperative imaging showed a subcutaneous cyst in 41 (62.1 percent), intraosseous tracking in three (4.5 percent), and intracranial extension in 15 (22.7 percent). Twelve patients (18.2 percent) had preoperative imaging that was inconsistent with intraoperative findings. Methylene blue was used in 17 cases and indigo carmine was used in one case. Intraoperative dye findings changed management in five cases, and in three cases a craniotomy was avoided without evidence of cyst recurrence. This report is the largest published series of midline dermoid cysts with intracranial extension. In almost 20 percent of cases, preoperative imaging was not consistent with intraoperative findings. Given disparate radiographic and intraoperative findings, methylene blue is a valuable tool that can facilitate appropriate, morbidity-sparing management of midline dermoid cysts. Therapeutic, IV.

Management of midline nasal dermoid lesions in children by external rhinoplasty.

ObjectivesNasal dermoid cysts are rare congenital lesions of ectodermal and mesodermal origin. Treatment of these cysts entails complete surgical excision, and several surgical incisions have been advocated. We present our experience utilizing an external rhinoplasty approach in seven children with nasal dermoid cysts and fistulae.MethodsA prospective study of 7 cases of nasal dermoid cysts and sinuses, diagnosed clinically and radiologically, were successfully treated by an external rhinoplasty approach in two teaching hospitals during the period of Apr 2011 to Nov 2013. Post operatively, an average follow-up of 12 months was observed by clinical examination, and the outcomes were documented and analysed.ResultsSeven children, 5 girls (71%) and 2 boys (29%), with ages ranging from 1.5 years to 16 years, who had nasal dermoid cysts and/or sinuses were successfully excised via an external rhinoplasty approach. The clinical presentation included midline facial swelling in five patients, a midline sinus in one patient and a dorsal midline nasal pit in one patient. No accessory tracts were found in these seven cases. Complete excision was achieved in 6 patients. There was one recurrence after 6 months with a successful complete resection with revision external rhinoplasty. All patients were followed up for an average of one year post operatively.ConclusionThe external rhinoplasty approach is an effective surgical approach in treating paediatric nasal dermoid cysts and sinuses with a very low incidence of recurrence.

The Usefulness of Three-Dimensional Reconstruction Computed Tomography in the Nasal Dermoid Cyst.

The Usefulness of Three-Dimensional Reconstruction Computed Tomography in the Nasal Dermoid Cyst.

Traitement de la stérilité et mélanome : question non résolue en 2016

The most common congenital midline nasal masses are nasal dermoid sinus cysts (NDSC) [Hughes GB, Sharpino G, Hunt W, Tucker HM. Management of the congenital midline nasal mass—a review. Head Neck Surg 1980;2:222–33.1]. Their clinical importance hinges on their potential to communicate with the central nervous system. Preoperative diagnosis of an intracranial extension allows for referral to a craniofacial team with the appropriate skills and experience for a transcranial approach. All patients with a NDSC require imaging with high resolution multiplanar MRI scans and complimentary fine cut CT scan to reveal the anatomical extent of the tract and its relationship to the anterior cranial fossa.A single-stage craniofacial approach to resection of midline NDSC extending to the anterior cranial base is effective with minimal morbidity [Yavuzer R, Bier U, Jackson IT. Be careful: it might be a nasal dermoid cyst. Plast Reconstr Surg 1999;103:2082–3; Denoyelle F, Ducroz V, Roger G, Garabedian EN. Nasal dermoid sinus cysts in children. Laryngoscope 1997;107:795–800; Rohrich RJ, Lowe JB, Schwartz MR. The role of open rhinoplasty in the management of nasal dermoid cysts. Plast Reconstr Surg 1999;104:2163–70; Rahbar R, Shah P, Mulliken JB, et al. The presentation and management of nasal dermoid—a 30-year experience. Arch Otolaryngol Head Neck Surg 2003;129:464–71; Posnick JC, Bortoluzzi P, Armstrong DC, Drake JM. Intracranial nasal dermoid sinus cysts: computed tomographic scan findings and surgical results. Plast Reconstr Surg 1994;93:745–54 [discussion 755–56]; Bartlett SP, Lin KY, Grossman R, Kratowitz J. The surgical management of orbitofacial dermoids in the pediatric patient. Plast Reconstr Surg 1993;91:1208–15.2, 3, 7, 9, 11, 18]. The cyst and tract are accessed through a combination of a nasal and transcranial approach. This allows visualisation and dissection of the tract with only a small incision on the nasal dorsum to include the cutaneous punctum when present. Transnasal endoscopic techniques have been advocated where the dermoid is located within the nasal cavity and there is little or no cutaneous involvement [Weiss DD, Robson CD, Mulliken JB. Transnasal endoscopic excision of midline nasal dermoid from the anterior cranial base. Plast Reconstr Surg 1998;101:2119–23.26].We present a review of five cases referred to our unit between 1999 and 2004 with a diagnosis of a midline nasal dermoid sinus cyst and radiological evidence of intracranial communication. All cases had a communication with the anterior cranial fossa diagnosed preoperatively and were treated surgically with a craniofacial approach. An intracranial extension was identified at operation in each case and this was confirmed on histopathology. The only significant complication resulted from an early postoperative infection, requiring re-operation. There were no recurrences and acceptable aesthetic outcomes have been observed in all cases.

Nasal Dermoid Cyst and Surgical Approach

Nasal Dermoid Cyst and Surgical Approach

Management of Nasal Dermoid Cyst via Open Rhinoplasty Approach

Nasal dermoid cysts are rare congenital anomalies whereas they constitute most of the midline nasal masses. These lesions are generally diagnosed at birth or within the early childhood. Nasal dermoid cysts may present with intracranial extension, so that MRI imaging should be used for preoperative planning. Complete excision and cosmetic appearance are the important factors in the management of these masses. In this study we present the report of a 16 year-old male patient who suffered from a congenital nasal mass where we performed complete dermoid cyst excision by performing open approach rhinoplasty and obtained a satisfactory result both aesthetically and functionally. Key Words: Nasal Dermoid Cyst; Rhinoplasty; Midline Nasal Mass.

Endoscopic removal of a dermoid cyst via scalp incision

Nasal dermoid sinus cysts are the most common congenital midline nasal lesions. We describe a novel technique for the excision of a nasal dermoid cyst in a 2-year-old boy using a four hand endoscopic approach via a small scalp incision behind the hairline. The technique, although somewhat challenging, avoids a facial scar.

Nasal dermoid cyst with intracranial extention and an atretic dermal sinus

Nasal dermoid cyst with intracranial extention and an atretic dermal sinus

Nasal Dermoid Sinus Cyst expanding into Frontal Sinus: A Rare Presentation

ABSTRACT Nasal dermoid sinus cysts are uncommon congenital anomalies that require interventions only when they present as complications. They frequently present in childhood as midline nasal masses requiring excision. They may present with intracranial as well as intraorbital extensions, making it necessary to subject the patient for proper radiological diagnosis preoperatively. Here, we present a rare case report of 28-year-old male patient who presented at our tertiary health care center with nasal dermoid cyst expanding into the frontal sinus causing proptosis and blurring of vision. The cyst was excised by combined approach, i.e. external nasal dermoid sinus tract excision and endoscopic nasofrontal sinusotomy for complete removal. The embryology, clinical history, diagnosis and surgical management are discussed. How to cite this article Gupta R, Gupta A, Budhiraja G, Francis AA. Nasal Dermoid Sinus Cyst expanding into Frontal Sinus: A Rare Presentation. Clin Rhinol An Int J 2012;5(3):123-126.

Oral Teratomas: A Report of 5 Cases

To present a case series of 5 patients with oral teratomas, discussing the treatment and follow-up. Five patients (4 girls and 1 boy) with oral teratomas presented at the Maxillofacial Surgery Department of a University Hospital with a reference population of 1,000,000 between 1980 and 2002. The associated lesions, clinical examination, histopathology, treatment and follow-up were registered and described. The newborns presented associated congenital malformations such as cleft palate, bifid tongue, dorso-nasal fistula and nasal dermoid cyst. In all 5 cases the tumor mass was excised at its base with surrounding normal tissue under general anesthesia combining conventional and electric scalpels. Histological analysis resulted in different compositions of multiple tissues typical of teratomas. After a mean follow-up of 8 years no sign of tumor recurrence had been detected. Teratomas were a rare finding within a large population of newborn patients. Five tumors were excised and histologically diagnosed as teratomas. No recurrence occurred after 8 years of follow-up.

Endonasal endoscopic approach for intracranial nasal dermoid sinus cysts in children

Nasal dermoid sinus cysts are the most common congenital midline nasal lesions. The frequency of intracranial extensions varies from 5% to 45%. Complete surgical excision of nasal dermoid cyst and any associated sinus tract is essential for cure and any residual ectodermal elements result in a high rate of recurrence and complicated infections.Many different approaches have been described for the removal of nasal dermoids in the past two decades, ranging from a simple extracranial excision to complex procedures in which a combined extracranial–intracranial approach is required.We hereby report two cases of nasal dermoid sinus cysts in children with intracranial extension which were managed with an endonasal endoscopic procedure. We describe the technique we implemented for this procedure and for the reconstruction of the skull base defect.

A Multitrabecular Nasal Dermoid Cyst

ABSTRACT Nasal dermoid is a rare developmental anomaly. Unlike other craniofacial dermoid, the nasal lesions can present as a cyst, a sinus or fistula and may have an intracranial extension. We report a case of 11-year-old male child presenting in the ENT OPD of Pravara Rural Hospital with a tuft of hair over the root of the nose since birth, which is uncommon presentation of nasal dermoid. How to cite this article Shinde KJ, Singh AK. A Multitrabecular Nasal Dermoid Cyst. Clin Rhinol Int J 2012;5(1):38-40.

Nasal dermoid cyst with intracranial extension and an atretic dermal sinus tract

Nasofrontal masses belong to the group of congenital midface anomalies (CMFA) in paediatric age group. Nasofrontal dermoids with patent dermal sinus tract is a rare anomaly resulting from the failure of normal embryogenic process. Most patients present in infancy or early childhood. CT and MRI together are usually required for definitive diagnosis. CT imaging provides vital information about the osseous involvement while MRI is crucial for evaluation of the intracranial extent and detailed tissue characterization. Knowledge of embryonic development is important in understanding the pathologies of nasofrontal masses in paediatric age group.

Unusual variants of midline nasal dermoid cysts: a series of three cases

Dermoids presenting in early life with a sinus tract along the midline of the nasal dorsum are well described. We present three very unusual variants of this condition. Case one was a two-year-old child with a pit in the philtrum of the lip. The tract pierced the nasal spine and extended towards the crista galli. Case two was a 15-month-old child with two separate sinus openings on the dorsum, one below and one above a dermoid cyst. Case three was a 17-year-old adolescent with neurological disability. Scanning showed a dermoid cyst deep in the anterior skull base, but the sinus tract had been obliterated by bony overgrowth due to long term use of antiepileptic medication. Cases one and two were successfully managed by complete excision via an external rhinoplasty approach. Case three, in contrast, was not operated upon due to bony obliteration of the sinus tract. Surgeons dealing with nasal dermoids must be able to adapt to the variable anatomical and clinical features of these lesions.

Witch Nose

Nasal dermoid cysts are one of the most frequent congenital pathologic lesions of the nasal area. These lesions may have intracranial extensions without any clinical evidence, which can be explained by the pathophysiologic development of the lesion, thought to be related to a delay or pause during the separation period of the dura and skin during embryogenesis. This factor is independent from the location and size of the lesion and may lead surgeons to misdiagnoses or inadequate treatments.In this article, 2 cases of nasal dermoid cysts localized at the tip of the nose are presented. Although these lesions can be seen anywhere from the root to the columella, nasal tip location is rare in previously published series. In the cases presented in this study, both patients are school-aged and are faced with social and psychologic problems, as their friends call them "witch nose," in reference to the lesion at the tip of the nose. Vertical tip incision for complete excision of these lesions was performed after accurate radiologic imaging of the brain and possible intracranial extension. No complications or recurrence was seen in either patient.Although the treatment of dermoid cysts is surgical, operative planning should be made after complete physical and radiologic examinations. As the lesion may lead to psychologic and social problems because of its appearance, especially in children, therapy should not be delayed.

Endoscopic resection of intracranial dermoid cysts

Nasal dermoid cysts are congenital lesions which are often diagnosed in infancy or childhood. However, a small number present in adulthood, and some extend intracranially. Traditional treatment for the intracranial portion of these cysts includes frontal craniotomy. Two intracranial dermoid cysts were resected via a transnasal endoscopic approach, using 70° nasal endoscopy for complete visualisation and intracranial tumour removal. We describe our technique for the procedure itself and for reconstruction of the skull base defect. The endoscopic transnasal skull base approach is an excellent alternative to a traditional frontal craniotomy, to achieve complete resection of intracranial dermoid cysts.

Nasal dermoid cyst extending through the frontal bone with no sinus tract in a Dalmatian

A Dalmatian was presented with a subcutaneous swelling in the dorsal midline between the eyes. No opening in the skin was identified at the dorsal nasal planum and there was no discharge. Positive contrast sinography showed contrast material filling a cyst that extended to the frontal bone. At surgery, the cyst had a tubular shape and was embedded in a fibrous dermal tissue strand running into the bony nasal septum. The nasal dermoid sinus cyst was surgically removed by limited dorsal rhinotomy, followed by excision of the remaining strand from a bony recess in the lamina perpendicularis ethmoidalis. It is proposed that this nasal dermoid cyst that extends through the frontal bone with no sinus tract is classified as a type V subtype c.