[Nasal congenital cysts and fistulas: clinical and surgical aspects]

Eight patients affected with cysts or fistulae on the midline at the nose bridge (back of the nose) have been treated at the Pediatric Surgery Service of the Hospital Sant Joan de Dèu in Barcelona from march 1995 to october 1996. Six patients had a cystic mass (four of them having an intranasal prolongation) and two had a fistulous orifice (one of them also having intranasal prolongation). The test with the highest diagnostic sensibility was the CT-scan, which showed a bifid crista galli and intranasal prolongation in 5 of the patients. Pathologic exam confirmed the diagnosis of dermoid cyst. At follow-up, all patients were doing well. Congenital cysts and fistulae at the nose bridge (back of the nose) may appear as a trivial condition; the possibility of them being the only clinical feature of an intranasal or intracranial prolongation is the reason for a deeper study in order to determine the extension of the lesion. The treatment is always surgical removal of the cyst and the fistulous pathway at the time of diagnosis, regardless of the patient's age, thus avoiding possible infectious complications.