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Nasal dermoid cyst: diagnosis and management of five cases
1Departments of ENT, CHR Citadelle, 4000 Liège.
Abstract:
Five cases of nasal dermoid cyst are presented. Three out of five cases were settled during childhood. Three presented a mass with a hole on the external nose with recurrent local infections. One case was wrongly referred for a dacryocystitis. The first one was detected during an infection of the cerebral extension and frontal abscess was assessed by CT scan and MRI. Two patients had other associated congenital abnormalities: hypotrophy of the external ear in one case, multiples malformations in an other. Adequate exposure and cosmetic results are sometimes contradictory to define the best surgical approach. Dermoid cysts and sinuses must be completely removed to prevent recurrence. External rhinoplasty and bicoronal approach are the main procedures for removing these lesions.
Insights
Nasal dermoid cysts, often presenting in childhood with external nose masses and infections, require complete surgical removal. Surgical approaches like external rhinoplasty aim for complete excision and good cosmetic outcomes.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Plastic Surgery
Background:
- Nasal dermoid cysts are congenital tumors that can present with varied clinical manifestations.
- Early diagnosis and management are crucial, especially when associated with infections or intracranial extension.
Observation:
- This study presents five cases of nasal dermoid cysts, with three diagnosed in childhood.
- Common presentations included external nasal masses with a central pore, recurrent infections, and misdiagnosis (e.g., dacryocystitis).
- One case involved intracranial extension with a frontal abscess, necessitating advanced imaging (CT, MRI).
- Associated congenital anomalies, such as ear hypotrophy and multiple malformations, were noted in two patients.
Findings:
- Complete surgical excision is essential to prevent recurrence of nasal dermoid cysts and sinuses.
- Surgical approaches must balance adequate exposure for complete removal with achieving favorable cosmetic results.
- External rhinoplasty and bicoronal approaches are frequently employed for effective lesion removal.
Implications:
- Optimal surgical strategy for nasal dermoid cysts requires careful consideration of lesion extent, associated anomalies, and cosmetic outcomes.
- Complete removal minimizes the risk of recurrence and associated complications like infections or intracranial spread.
- Multidisciplinary collaboration may be beneficial for managing complex cases with associated abnormalities.