Management of midline nasal dermoid lesions in children by external rhinoplasty

OBJECTIVES: Nasal dermoid cysts are rare congenital lesions of ectodermal and mesodermal origin. Treatment of these cysts entails complete surgical excision, and several surgical incisions have been advocated. We present our experience utilizing an external rhinoplasty approach in seven children with nasal dermoid cysts and fistulae. METHODS: A prospective study of 7 cases of nasal dermoid cysts and sinuses, diagnosed clinically and radiologically, were successfully treated by an external rhinoplasty approach in two teaching hospitals during the period of Apr 2011 to Nov 2013. Post operatively, an average follow-up of 12 months was observed by clinical examination, and the outcomes were documented and analysed. RESULTS: Seven children, 5 girls (71%) and 2 boys (29%), with ages ranging from 1.5 years to 16 years, who had nasal dermoid cysts and/or sinuses were successfully excised via an external rhinoplasty approach. The clinical presentation included midline facial swelling in five patients, a midline sinus in one patient and a dorsal midline nasal pit in one patient. No accessory tracts were found in these seven cases. Complete excision was achieved in 6 patients. There was one recurrence after 6 months with a successful complete resection with revision external rhinoplasty. All patients were followed up for an average of one year post operatively. CONCLUSION: The external rhinoplasty approach is an effective surgical approach in treating paediatric nasal dermoid cysts and sinuses with a very low incidence of recurrence.