Endoscopic-assisted, closed rhinoplasty approach for excision of nasoglabellar dermoid cysts

Abstract

Objective/Hypothesis: To report the feasibility and early results of a new surgical technique for excision of nasoglabellar dermoid cysts.Study Design: Retrospective case series. Methods: Patients with nasoglabellar dermoid cysts without intracranial communication were treated with the endoscopic-assisted, closed rhinoplasty approach. Data pertaining to patient characteristics, surgical outcome, and cosmetic results were obtained by retrospectively reviewing medical records.Results: Three patients were included in the study. The endoscopic-assisted, closed rhinoplasty approach was utilized in all patients. In each case, complete excision was achieved without violation of the cyst wall. All patients had satisfactory cosmetic results as assessed by subjective evaluation by the parent(s) and surgeon.Conclusions: The endoscopic-assisted, closed rhinoplasty approach allows for safe and complete excision of uncomplicated nasoglabellar dermoid cysts. This new surgical technique should be considered in children with benign, midline nasal, and forehead masses due to its ease and excellent cosmetic results.

Resection of intracranial nasal dermoid sinus cyst by endoscopic-assisted open rhinoplasty approach

“…One of the main points of the treatment of this congenital lesion is to achieve a complete resection, because incomplete removal has been associated with a high recurrence rate (9) . A variety of techniques have been described to resect these cysts, but traditional treatment is based on open craniofacial approaches.…”

“…The advancements and the trend toward less invasive techniques stimulated the use of other approaches like rhinoplasty for the treatment of these lesions. This fact allowed to get a complete resection of the NDSC and improve the morbidity with better aesthetics results through an open or closed rhinoplasty (7)(8)(9)14) . However, all these new approaches were excluded in cases of intracranial involvement, requiring again more invasive approaches (10,15) .…”

“…With the evolution of surgical techniques, more conservative procedures have been described trying to reduce mobility and improve the aesthetic results (4) . Open or closed rhinoplasty approaches, alone or with endoscopic-assistance, have been successfully used to complete resection with better aesthetics results (7)(8)(9) . However, intracranial involvement has been described as a limiting factor for this type of less invasive approaches (10) .…”

Management of Congenital Midline Nasofrontal Masses: Case Report and Review of Literature

“…The transnasal approaches may be easier to perform in patients where skin laxity is favourable, such as the elder patient. However, it has been described in young patients as well [ 18 ]. Other external approaches such as the medial brow incision or a lateral rhinotomy provide good exposure at the cost of a potentially unfavourable scar.…”

“…The primary concern in the case presented here was a complete surgical excision given the high recurrence rates reported when the cyst capsule is disrupted [ 15 ]. In spite of the cosmetic advantages of the endoscopic forehead or rhinoplasty approaches [ 4 , 8 , 18 ], such procedures usually entail risks of general anaesthesia and higher costs and may be more time consuming. Nonetheless, it may be preferable to some patients when given the option.…”