A superficial nasal dermoid cyst excised through a novel horizontal zig-zag incision in a 49-year-old man

Abstract

A dermoid cyst of the nose is a relatively rare anomaly seen normally in the first few years of life. They are distinct to dermoid cysts located elsewhere in the body as there is a potential for extension to intracranial structures. Presentation in adulthood is rare and often because of a missed diagnosis in childhood. We present the case of an adult man with a superficial nasal dermoid cyst presenting over the nasion. The operation was performed by direct excision at the nasion with a novel modified horizontal zigzag skin incision, instead of the traditional vertical excision, with a good cosmetic result. The cyst was radically excised and there was no evidence of extension intracranially. The case is discussed in relation to the current surgical literature in both children and adults.

Endoscopy‐assisted excision of nasoglabellar dermoid cyst

“…CT can be used to assess the bony anatomy associated with nasal dermoid cyst. We agree with Wales et al, 4 Santamaría‐Gadea et al 2 and Rahbar et al 1 to recommend that initial investigation in adults should be CT to define bony anatomy and affection and if there is an intracranial extension concern, MRI to determine intracranial extension and operative planning.…”

“…CT can be used to assess the bony anatomy associated with nasal dermoid cyst. We agree with Wales et al,4 Santamaría-Gadea et al2 and Rahbar et al1 to recommend that initial investigation in adults should be CT to define bony anatomy and affection and if there is an intracranial extension concern, MRI to determine intracranial extension and operative planning.We agree with Rahbar et al1 that CT should be included in nasal dermoid workup, and complementary MRI is mandatory if there is concern for intracranial extension. Hartley et al6 proposed radiological classification of nasal dermoids into four groups: superficial, intraosseus, intracranial extradural and intracranial intradural, to allow better surgical planning.…”

“…The nasal dermoid cyst is relatively rare and different from other dermoid cysts elsewhere because of its potential extension to deeper and/or intracranial structures exposing patient to risk of meningitis, convulsions, intracranial or orbital abscess or cavernous sinus thrombosis with infection 2,3 . Adulthood presentation is rare and often because of missed diagnosis at childhood 4 …”

“…2,3 Adulthood presentation is rare and often because of missed diagnosis at childhood. 4 Many surgical approaches have been suggested according to cyst site. Open rhinoplasty or transnasal endoscopic approach to simple nasal dermoid cysts is generally used in children.…”