Archives of Medicine and Health Sciences

TEACHING IMAGES
Year
: 2019  |  Volume : 7  |  Issue : 2  |  Page : 311--312

Nasal dermoid


Satvinder Singh Bakshi 
 Department of ENT and Head and Neck Surgery, All India Institute of Medical Sciences, Mangalagiri, Guntur, Andhra Pradesh, India

Correspondence Address:
Dr. Satvinder Singh Bakshi
House Number 1A, Selvam Apartments, 71 Krishna Nagar Main Road, Krishna Nagar, Puducherry - 605 008
India

Abstract

Nasal dermoid is a rare developmental anomaly arising from a cluster of epithelium trapped during the embryological development or failure of obliteration of the ectodermal extension. Progressive enlargement can lead to soft tissue or skeletal deformity or intracranial complications such as meningitis or abscess. Timely diagnosis and complete surgical excision are essential to avoid complications. We describe a 23 year old male presenting with nasal dermoid.



How to cite this article:
Bakshi SS. Nasal dermoid.Arch Med Health Sci 2019;7:311-312


How to cite this URL:
Bakshi SS. Nasal dermoid. Arch Med Health Sci [serial online] 2019 [cited 2020 Sep 28 ];7:311-312
Available from: http://www.amhsjournal.org/text.asp?2019/7/2/311/273072


Full Text



A 23-year-old male presented with a gradually increasing swelling on the root of the nose for 8 months. On examination, a firm 2 cm × 2 cm cystic swelling was seen at the root of the nose [Figure 1], and the rest of physical examination was normal. A provisional diagnosis of dermoid cyst was made. Magnetic resonance imaging (MRI) scan [Figure 2] was done to look for intracranial extension, but none was found. The patient underwent excision of the cyst, and postoperative biopsy was confirmatory [Figure 3]. He is asymptomatic at 1 year of follow-up.{Figure 1}{Figure 2}{Figure 3}

 Discussion



Nasal dermoid is a rare developmental anomaly and was first described in 1817 by Cruveleir.[1] It arises from a cluster of epithelium trapped during the embryological development or failure of obliteration of the ectodermal extension.[1] The incidence of nasal dermoids is 1 per 20.000-40,000 births and they account for 1-3% of all dermoids.[1],[2] The lesion can present as cyst, sinus, or fistula and may have an intracranial extension. Concomitant congenital anomalies such as absent third ventricle, spinal anomalies, preauricular sinuses, and midline facial defect such as cleft lip have been reported.[2] The presence of associated anomalies increases the likelihood of intracranial extension.

Progressive enlargement of the nasal dermoid can lead to soft tissue or skeletal deformity, local infection, or intracranial complications such as meningitis or abscess.[1] MRI is valuable for defining the intracranial as well as extracranial extent; however, the tract is better visualized by a computed tomographic scan.[3] Timely diagnosis and complete surgical excision are essential to avoid complications. The cyst can be locally excised; however, those with intracranial extension require a combined craniofacial approach.[1]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Herrington H, Adil E, Moritz E, Robson C, Perez-Atayde A, Proctor M, et al. Update on current evaluation and management of pediatric nasal dermoid. Laryngoscope 2016;126:2151-60.
2Opsomer D, Allaeys T, Alderweireldt AS, Baert E, Roche N. Intracranial complications of midline nasal dermoid cysts. Acta Chir Belg 2019;119:125-8.
3Rodriguez DP, Orscheln ES, Koch BL. Masses of the nose, nasal cavity, and nasopharynx in children. Radiographics 2017;37:1704-30.