Hostname: page-component-84b7d79bbc-g78kv Total loading time: 0 Render date: 2024-07-25T09:53:01.919Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  04 November 2011

R Locke*
Affiliation:
Department of Paediatric Otolaryngology, Royal Hospital for Sick Children, Glasgow, Scotland, UK
H Kubba
Affiliation:
Department of Paediatric Otolaryngology, Royal Hospital for Sick Children, Glasgow, Scotland, UK
*
Address for correspondence: Mr Richard Locke, Department of Paediatric Otolaryngology, Royal Hospital for Sick Children, Yorkhill, Glasgow G3 8SJ, Scotland, UK E-mail: richard.locke7@ntlworld.com

Abstract

Objective:

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.

Methods:

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.

Results:

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.

Conclusion:

Surgeons dealing with nasal dermoids must be able to adapt to the variable anatomical and clinical features of these lesions.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented in part at the 10th International Congress of the European Society of Paediatric Otolaryngology, Ampiona, Spain, June 2010

References

1Crawford, J, Webster, J. Congenital dermoid cyst of the nose. Plast Reconstr Surg 1959;9:235–40CrossRefGoogle Scholar
2Pratt, LW. Midline cysts of the nasal dorsum: embryologic origin and treatment. Laryngoscope 1965;75:968–80CrossRefGoogle Scholar
3Nydell, C, Masson, J. Dermoid cysts of the nose: a review of 39 cases. Ann Surg 1959;6:1007–16CrossRefGoogle Scholar
4Charrier, J, Rouillon, I, Roger, G, Denoyelle, F. Craniofacial dermoids: an embryological theory unifying nasal dermoid sinus cysts. Cleft Palate Craniofac J 2005;42:51–7CrossRefGoogle ScholarPubMed
5Blake, W, Cow, C, Holmes, A, Meara, J. Nasal dermoid sinus cysts a retrospective review and discussion of investigation and management. Ann Plast Surg 2006;5:355540Google Scholar
6Zapata, S, Kearns, DB. Nasal dermoids. Curr Opin Otolaryngol Head Neck Surg 2006;14:406–11CrossRefGoogle ScholarPubMed
7Brunner, H, Donnelly, W. Nasal and auricular fistulae. Plast Reconstr Surg 1947;2:497504CrossRefGoogle ScholarPubMed
8Tiwari, R. Dermoid cyst with tubular bifurcation and dermal sinus. Postgrad Med J 1967;43:550–1CrossRefGoogle ScholarPubMed
9Charrier, J, Rouillon, I, Roger, G, Denoyelle, F, Collon, S, Garabedian, E. Congenital isolated midline sinus of the upper lip: clinical and embryological approaches. Cleft Palate Craniofac J 2006;43:488–91CrossRefGoogle ScholarPubMed
10Sancho, M, Albert, A, Cusi, V, Grande, C, Aguilar, C, Morales, L. Upper lip fistulas: three new cases. Cleft Palate Craniofac J 2002;39:457–60Google Scholar
11Asahina, I, Sakakibara, T, Miyashin, M, Tachikawa, N, Enomoto, S. Congenital midline sinus of the upper lip: case report and review of literature. Cleft Palate Craniofac J 1997;34:83–5CrossRefGoogle ScholarPubMed
12Illing, H, Field, D, McNamara, M, Sandy, R. Congenital sinus of the upper lip. A case report. Int J Oral Maxillofac Surg 1999;1:2930CrossRefGoogle Scholar
13Bilkay, U, Gundogan, H, Ozek, C, Tokat, C, Gurler, T, Songur, E et al. Nasal dermoid sinus cysts and the role of open rhinoplasty. Ann Plast Surg 2001;47:813Google Scholar
14Bloom, D, Carvalho, D, Dory, C, Brewster, D, Wickersham, J, Kearns, D. Imaging and surgical approach of nasal dermoids. Int J Pediatr Otorhinolaryngol 2002;62:111–22CrossRefGoogle ScholarPubMed
15Chow, K, Szeto, C. Cerebral atrophy and skull thickening due to chronic phenytoin therapy. Can Med Assoc J 2007;3:321–3Google Scholar