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Nasal dermoid sinus cysts in children
F Denoyelle1, V Ducroz, G Roger
1Department of Pediatric Otolaryngology and Head and Neck Surgery, Armand Trousseau's Children's Hospital, Paris, France.
Insights
Nasal dermoid sinus cysts in children were treated using various surgical techniques. The external rhinoplasty approach with medial crura section demonstrated a low recurrence rate and favorable aesthetic outcomes.
Area of Science:
- Pediatric Otolaryngology
- Craniofacial Surgery
Background:
- Nasal dermoid sinus cysts are congenital midline masses.
- These cysts can present as midline cysts, nasal pits, or combined.
- Intracranial extension is a potential complication requiring careful evaluation.
Purpose of the Study:
- To evaluate surgical outcomes for pediatric nasal dermoid sinus cysts.
- To compare the efficacy of different surgical approaches.
- To identify the optimal surgical technique for minimizing recurrence and maximizing aesthetic results.
Main Methods:
- Retrospective review of 36 pediatric patients treated between 1974 and 1994.
- Analysis of three surgical techniques: external rhinoplasty with medial crura section, direct median approach, and paracanthal approach.
- Assessment of recurrence rates, aesthetic results, and complications including intracranial extension and meningeal adherence.
Main Results:
- External rhinoplasty with medial crura section was performed in 23 cases.
- The external rhinoplasty group showed a low recurrence rate (two superficial recurrences) and good aesthetic results.
- Other approaches included direct median (7 cases) and paracanthal (6 cases).
- Six patients had signs of intracranial extension, and two had meningeal adherences.
Conclusions:
- The external rhinoplasty approach with medial crura section is recommended for treating nasal dermoid sinus cysts in children.
- This technique offers a wide surgical field, low recurrence rates, and superior aesthetic outcomes.
- Careful presurgical evaluation for intracranial extension is crucial.
Abstract:
Thirty-six children with nasal dermoid sinus cysts were treated in the Department Pediatric Otolaryngology, Armand Trousseau's Children's Hospital (Paris, France) between 1974 and 1994. Ten of the patients presented with a midline cyst only, eight had nasal pits only, and 18 had combined cases. In six of the 36 patients, presurgical imagery indicated signs of intracranial extension of the tract, reaching the foramen caecum without intracranial mass. Three surgical techniques were used: an external rhinoplasty approach with medial crura section in 23 cases, a direct median approach in seven cases, and a paracanthal approach in six cases. Only two cases had meningeal adherences. Two superficial recurrences occurred within the 7-year follow-up period. Widening of the scar occurred in four children after verticomedian approach or nasal pit excision. The external rhinoplasty procedure with medial crura section results in a wide surgical approach, low recurrence rate, and good aesthetic results.