Nasal Dermoid Sinus Cyst

Abstract

Midline congenital abnormalities of the skin may be related to subjacent visceral developmental defects. We report on three unrelated children presenting a small midline pit on the bridge of the nose from which a small tuft of hair was emerging. This presentation is the hallmark of a nasal dermoid sinus cyst. In one of the patients the sinus tract was connected to the anterior cerebral fossa and required neurosurgical management. Although midline cutaneous abnormalities may look trivial, dermatologists should keep a high index of suspicion for possible association with more severe underlying defect. The diagnosis of nasal dermoid sinus cyst requires appropriate imaging studies to determine the extension of the sinus tract thus allowing proper management.

Nasal dermoid sinus cyst in a young female

“…[56] Nasal encephalocele presents a soft compressible bluish swelling which changes in size on crying or straining (Valsalva maneuver) and shows transillumination due to its cerebrospinal fluid content. Our patient presented with the classical picture of nasal dermoid sinus cyst with history of intermittent discharge of pus and on examination she had pathognomonic tufts of hair arising from the opening of the sinus.…”

Congenital Lesions of Tip of Nose: Report of Two Cases with Review

“…These lesions are common over the lower third of the nasal bridge. The differential diagnosis for midline nasal swelling includes nasal gliomas, nasal encephalocele, congenital heamangiomas, and epidermoid cyst [10] [11]. Nasal encephalocele presents a soft compressible bluish swelling which changes in size on crying or straining (Valsalva maneuver) and shows transillumination due to its cerebrospinal fluid content [6].…”

Midline Craniofacial Masses in Children

“…Consequently, hair may emerge through the sinus opening and is diagnostic. 7 If dermis and skin adnexa are not present within the lining of the lesion, the lesion is termed a simple epidermoid inclusion cyst.…”

“…These lesions can present as a small pit or blind sinus, a fistula extending into nasal structures, or a single or multiloculated nodulocystic lesion. 7 Cystic lesions present as firm, nonpulsating, non-transilluminating, noncompressible, and nonpainful nodules with or without a sinus tract, which is visible as a small opening in the midline. This external ostium or punctum is frequently seen in nasal dermoid lesions, whereas it is an uncommon feature of lesions in the orbital and lower forehead area.…”