The presentation and management of nasal dermoid - A 30-year experience

Objective: To review the presentation of nasal dermoid in children and present guidelines for its management. Design: Retrospective study (January 1, 1970, through December 31, 2000). Setting: Tertiary-care pediatric medical center. Patients: Number of patients: 42 (28 boys and 14 girls). Intervention: Extensive review of the initial presentation, significant family and medical history, workup, surgical approach, complication, and rate of recurrence. Results: Mean age of presentation was 32 months. The most common presentation was a nasoglabellar mass, in 13 patients (31%). Five patients presented with an associated craniofacial abnormality. Thirty-nine patients (93%) underwent a preoperative imaging workup. Thirty-one (74%) did not show any clinical and/or radiographic indication of intracranial extension. Thirty-four (81%) underwent extracranial. excision, and 8 (19%) underwent combined intracranial-extracranial excision. Five patients (12%) presented with recurrence, extracranially in 4 and intracranially in 1. No other complication was noted, with a mean follow-up of 7 years. Conclusions: Nasal dermoid is a rare congenital anomaly. Preoperative evaluation is essential to rule out intracranial extension. Surgical strategy depends on the location and extent of the lesion, ranging from local excision to a combined intracranial-extracranial approach. Recurrence is uncommon and often easily managed.