Table of Contents  
LETTER TO THE EDITOR
Year : 2013  |  Volume : 6  |  Issue : 3  |  Page : 347-348  

Nasal dermoid cyst with intracranial extention and an atretic dermal sinus


Department of ENT, Padmashree Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr. D Y Patil Vidyapeeth, Pimpri, Pune, India

Date of Web Publication5-Jul-2013

Correspondence Address:
Nayanna S Karodpati
Department of ENT, Padmashree Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr D Y Patil Vidyapeeth, Pimpri, Pune - 411 018
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.114668

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How to cite this article:
Shinde VV, Karodpati NS, Deogaonkar S C, Ingale MH. Nasal dermoid cyst with intracranial extention and an atretic dermal sinus. Med J DY Patil Univ 2013;6:347-8

How to cite this URL:
Shinde VV, Karodpati NS, Deogaonkar S C, Ingale MH. Nasal dermoid cyst with intracranial extention and an atretic dermal sinus. Med J DY Patil Univ [serial online] 2013 [cited 2021 Apr 20];6:347-8. Available from: https://www.mjdrdypu.org/text.asp?2013/6/3/347/114668

Sir,

To complement the case report Nasal dermoid cyst with intracranial extention and an atreticdermal sinus tract by Singh et al, [1] we would like to throw light on the clinical aspect and management of such cases.

The Nasal dermoid sinus cyst [NDSC] anomalies tend to be variable and form no consistent pattern. [2] CT and MRI have become the gold standard in radiological evaluation of nasal dermoid. [1],[2],[3],[4]

Although 50% of nasal dermoids are diagnosed at birth, and 85% before age of 5 years, the average age at operation is 12.3 years. Surgical excision is the definitive treatment. Curettage and other limited procedures are inadequate and will lead to recurrence. It is vital to remove all squamous epithelium and hairs. [5] For NDSC in the absence of an intracranial cyst, the entire tract from the skin to the skull base should be excised. An elliptical incision is taken around the sinus opening. Since the tract passes deep to the nasal bones, medial osteotomies may be required. Alternatively, lateral osteotomies can be performed and the bony nasal vault raised as a unit with the overlying skin. The tract is followed superiorly until the base of the skull, ligated and excised. Should the preoperative investigation show an intracranial cyst, then a combined craniofacial procedure with neurosurgical consultation would be required. [2]

The reported case had two midline swellings over nasal bridge with a punctum. She had telecanthus and had undergone keratoplasty for coloboma of iris. A combined approach by a neurosurgeon and ENT surgeon was done to excise nasal dermoid sinus cyst through frontal craniotomy and open rhinotomy approaches. Histopathologically, it was a trichilemmal cyst.

 
  References Top

1.Singh V, Sehrawat S, Kharat A, Kuber R. Nasal dermoid cyst with intracranial extention and an atretic dermal sinus tract. Med J D Y Patil Univ 2012;5:1.  Back to cited text no. 1
    
2.Zeitonni AG,Shapiro RS. Congenital anomalies of the nose and anterior skull base. In: Tewfik TL, Vazken M. Der Kaloustian, editors. Congenital anomalies of the ear, nose and throat.Montreal, Canada: Quebec; 1997. p. 189-200.  Back to cited text no. 2
    
3.Blake WE, Chow CW. Nasal dermoid sinus cysts- A retrospective review and discussion of investigation and management. Ann Plast Surg 2006;57:535-40.  Back to cited text no. 3
    
4.Rahbar R, Shah P. The presentation and management of nasal dermoid- A 30 year experience. Arch Otolaryngol Head Neck Surg 2003;129:464-71.  Back to cited text no. 4
    
5.Mac Gregor FB, Geddes NK. Nasal dermoids- the significance of a midline punctum. Arch Dis Child 1993;68:418-9.  Back to cited text no. 5
    




 

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