Surgical approaches for nasal dermal sinus cysts

Area of Science:

• Craniofacial surgery
• Pediatric surgery
• Neurosurgery

Background:

• Nasal midline masses of ectodermal origin include nasal dermoids (ND) and nasal dermal sinus cysts (NDSC).
• Nasal dermal sinus cysts (NDSC) are distinguished by intracranial-extradural extension, unlike ND which are confined to the nasal dorsum, medial canthus, or glabella.
• Management of NDSC requires careful consideration of surgical approach to minimize morbidity and cosmetic impact.

Purpose of the Study:

• To present the management and surgical technique for nasal dermal sinus cysts (NDSC).
• To compare the outcomes of a novel surgical approach for NDSC with existing literature.
• To evaluate the efficacy and safety of the described surgical technique for NDSC.

Main Methods:

• Retrospective review of 11 patients with nasal dermal sinus cysts (NDSC).
• Description of a new surgical approach involving simple excision and mobilization of the pit, with proximal resection via a coronal transfrontal approach.
• Analysis of surgical technique, including considerations for osteotomy and preservation of the nasal bony-cartilaginous junction.

Main Results:

• A novel surgical approach was applied to four patients, avoiding the visible scarring associated with a previous transfacial approach.
• No recurrence of NDSC was observed in the 7 surgically treated patients.
• Mean follow-up duration was 3.9 years (range 0.5-7.2 years).

Conclusions:

• The described surgical approach is effective for managing nasal dermal sinus cysts (NDSC).
• Careful surgical technique is crucial to prevent nasal growth impairment.
• The novel approach offers a viable alternative with reduced cosmetic complications.