gms | German Medical Science

Introduction: Nasal dermoids are rare and although most of lesions are superficial, it may end deeply into the nose or extend intracranially. This study reviews the clinical characteristics and imaging findings as well as the appropriate surgical approach adopted for children managed in Mansoura University Hospitals.

Methods: A retrospective analysis was performed in 29 patients admitted for management of nasal dermoid over a 10 year period at the Otolaryngology department of our tertiary referral university hospital. Recorded data included patient’s demographics, initial complaint, site of the lesion, radiological findings, surgical technique, intra-operative findings, and post-operative outcome.

Results: The mean age at presentation was 2.5 years. Twenty-seven children presented with a nasofrontal swelling of which 20 had an apparent sinus. Other presentations included a swelling in the inner canthum (1), nasal tip and columella (1). Nine (31%) patients had a history of infection and two patients gave a positive history of meningitis. Intracranial extradural extension was identified in 10 patients (34.5%) during preoperative imaging. Surgical approaches included local excision and direct closure (12), open rhinoplasty (7), bicoronal excision and craniotomy (10). In 9 cases, the tract was adherent to the dura but was carefully dissected and in one case resection required excision of a segment of dura and reconstruction. In follow up period of 1-8 years, recurrence was detected in one case and the cosmetic results were satisfactory.

Conclusions: Those lesions are rare and require early precise surgical planning to achieve complete en bloc excision. This study reports a low morbidity associated with management of nasal dermoids with intracranial extension.

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