Un Skull base dermoid cyst fistulizing to the nasal tip in a pediatric patient: case report

Main Article Content

Martín Pinzón
Catalina Jaramillo-Moncayo
Manuela Orozco-Naranjo

Abstract

The dermoid cyst is a rare congenital lesion, secondary to an incomplete regression of ectodermal tissue. It’s incidence is 1/20,000-40,000 live births. Timely surgical resection must be performed to prevent intracranial involvement and/or complications. Imaging study determines it’s extension. Different surgical approaches have been recommended, all must adhere to Pollock’s 4 principles. The following study presents the case of a pediatric patient, 9 months old, with a dermoid cyst at the skull base with a fistulous path to the nasal tip. Contrasted nuclear magnetic resonance revealed a cystic mass in the region anterior to the crista galli communicated with a fistulous tract at the nasal tip. The patient was taken to surgery for cyst resection by external rhinoplasty combined with a transnasal endoscopic approach with satisfactory functional and aesthetic results, without recurrence. A Cerebrospinal fluid fistula was evidenced, as an intraoperative complication, it was corrected in the same surgical time.

Downloads

Download data is not yet available.

Article Details

How to Cite
1.
Pinzón M, Jaramillo-Moncayo C, Orozco-Naranjo M. Un Skull base dermoid cyst fistulizing to the nasal tip in a pediatric patient: case report. Acta otorrinolaringol cir cabeza cuello [Internet]. 2022Jan.31 [cited 2024Nov.21];49(4):304 -309. Available from: https://revista.acorl.org.co/index.php/acorl/article/view/555
Section
Reportes de Casos
Author Biography

Catalina Jaramillo-Moncayo, Fundación Universitaria Ciencias de La Salud

Médica egresada de La Universidad de Los Andes, Bogotá - Colombia. 

Residente del programa de Otorrinolaringología de La Fundación Universitaria Ciencias de La Salud, Hospital de San José. Bogotá - Colombia.

References

Herrington H, Adil E, Moritz E, Robson C, Perez-Atayde A, Proctor M, et al. Update on current valuation and management of pediatric nasal dermoid. Laryngoscope. 2016;126(9):2151-60. doi: 10.1002/lary.25860

Pratt L. Midline cyst of the nasal dorsum: Embryologic origin and treatment. Laryngoscope. 1965;75:965-80. doi: 10.1288/00005537-196506000-0010

Denoyelle F, Ducroz V, Roger G, Garabedian EN. Nasal dermoid sinus cysts in children. Laryngoscope. 1997;107(6):795-800. doi: 10.1097/00005537-199706000-00014

Makhdoom N, Abo El Ezz TA, Abdel-Haleem M. Management of midline nasal dermoid lesions in children by external rhinoplasty. J Taibah Univ Med Sci. 2017;12(4):324-28. doi: 10.1016/j.jtumed.2017.02.003

Leperchey F, Cotin G, Bodard M, Garabedian N, Klap P. Deux modalités dans le processus embryogénique des kystes et fistules fronto-nasaux [2 modalities in the embryogenic process of frontonasal cysts and fistulae]. Ann Otolaryngol Chir Cervicofac. 1983;100(4):247-54.

Winterton RIS, Wilks DJ, Chumas PD, Russell JL, Liddington MI. Surgical correction of midline nasal dermoid sinus cysts. J Caniofacial Surg. 2010;21(2):295-300. doi: 10.1097/SCS.0b013e3181cf5f44

Kadom N, Sze RW. Radiological reasoning: Pediatric midline nasofrontal mass. Am J Roentgenol. 2010;194(3 SUPPL.):10-13. doi: 10.2214/AJR.07.7126

Ortlip T, Ambro BT, Pereira KD. Midline approach to pediatric nasofrontal dermoid cysts. JAMA Otolaryngol Head Neck Surg. 2015;141(2):174-77. doi:10.1001/jamaoto.2014.3185

Cheng J, Kazahaya K. Management of pediatric nasal dermoids with intracranial extension by direct excision. Otolaryngol Head Neck Surg. 2013;148(4):694-96. doi: 10.1177/0194599812474424

Bilkay U, Gundogan H, Ozek C, Tokat C, Gurler T, Songur E, et al. Nasal dermoid sinus cysts and the role of open rhinoplasty. Ann Plast Surg. 2001;47(1):8-14. doi: 10.1097/00000637-200107000-00002

Pollock RA. Surgical approaches to the nasal dermoid cyst. Ann Plast Surg. 1983;10(6):498-01. doi: 10.1097/00000637-198306000-00012

Re M, Tarchini P, Macrì G, Pasquini E. Endonasal endoscopic approach for intracranial nasal dermoid sinus cysts in children. Int J Pediatr Otorhinolaryngol. 2012;76(8):1217-22. doi: 10.1016/j.ijporl.2012.05.004

Livingstone DM, Brookes J, Yunker WK. Endoscope-assisted nasal dermoid excision with an open rhinoplasty approach. Int J Pediatr Otorhinolaryngol. 2018;109:101-3. doi: 10.1016/j.ijporl.2018.03.035

Soni RS, Choudhry OJ, Liu JK, Eloy JA. Postoperative cerebrospinal fluid leak after septoplasty: A potential complication of occult anterior skull base encephalocele. Allergy Rhinol (Providence). 2013;4(1):e41-4. doi: 10.2500/ar.2013.4.0043

Kryzanski JT, Annino DJ, Gopal H, Heilman CB. Low complication rates of cranial and craniofacial approaches to midline anterior skull base lesions. Skull Base. 2008;18(4):229-42. doi: 10.1055/s-2007-1003924.

Most read articles by the same author(s)