Intracranial nasal dermoid sinus cysts: computed tomographic scan findings and surgical results

From July 1987 to January 1991, 14 patients, ages 1 to 19 years (mean 6 years), were seen with nasal dermoid sinus cysts, a congenital lesion with the potential for intracranial extension. Each patient was assessed clinically for cyst location, symptoms, associated craniofacial deformity, and other congenital anomalies. In 5 (36 percent) of the 14 patients, ages 4 to 48 months (mean 25 months), computed tomographic scans indicated indirect signs of intracranial extension, which were confirmed intraoperatively and histologically in all 5 patients. After neurosurgical consultation, a combined single-stage intracranial-extracranial approach was used to excise the lesion. No perioperative complications occurred. Clinical assessment (follow-up 20 to 40 months, mean 31 months), confirmed by postoperative CT scan 1 year after surgery, indicated no evidence of recurrence, residual skeletal contour defects, or deformity; forehead and nasal growth were qualitatively normal, and scar appearance was satisfactory. Our experience indicates that intracranial extension of nasal dermoid sinus cysts seen at a tertiary care referral center are not rare, that computed tomography scan permits accurate diagnosis, and that the single-stage intracranial-extracranial approach to resection is effective and results in minimal morbidity.