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Nasal glioma: is dermis involvement significant?
H G Thomson1, M M al-Qattan, L E Becker
1Division of Plastic Surgery, Hospital for Sick Children, Ontario, Canada.
Annals of Plastic Surgery
|February 1, 1995
Summary
Nasal gliomas, rare congenital masses, can be associated with naso-ocular clefts. A revised surgical protocol significantly reduced tumor recurrence in patients with nasal glioma.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Neurosurgery
Background:
- Nasal gliomas are rare, benign congenital tumors composed of sequestered glial tissue.
- These tumors can be associated with naso-ocular clefts, which may be subtle or overlooked.
Purpose of the Study:
- To review outcomes of nasal glioma treatment, focusing on recurrence rates and the significance of associated naso-ocular clefts.
- To evaluate the impact of a revised surgical protocol on nasal glioma recurrence.
Main Methods:
- Retrospective review of seven patients with nasal glioma treated over 28 years.
- Analysis of tumor recurrence patterns and association with naso-ocular clefts.
- Implementation and assessment of a new surgical protocol since 1972, involving frozen section analysis for deep resection margins and complete overlying skin excision when indicated.
Main Results:
- Three of seven patients had an associated ipsilateral naso-ocular cleft.
- The first two tumors treated under the previous protocol recurred within 10 months.
- No recurrences were observed after the implementation of the revised surgical protocol in 1972, which included precise margin assessment and appropriate skin excision.
Conclusions:
- The association between nasal glioma and naso-ocular clefts is likely underestimated.
- A meticulous surgical approach with intraoperative frozen section analysis for deep resection margins and judicious excision of adhered overlying skin can prevent recurrence of nasal glioma.
- This refined protocol avoids unnecessary intracranial procedures while maintaining low recurrence rates.