Our experiences with congenital midline nasal dermoid sinus cyst

Abstract

Introduction: Nasofrontal dermoid sinus cysts (NDSC) are rare congenital malformations. NDSCs are distinct from other facial dermoids in their potential for involving deeper contiguous structures and intracranial extension. The development of this congenital midline sinus of dorsum of nose has opened a new horizon in current concepts of embryology. Objective: To study the embryological origin, presentation, treatment, and genetic associations of three cases of these sinus cysts. Clinical presentation: This paper presents our experiences with managing three patients who presented with opening on nasal dorsum with recurrent swelling and purulent discharge from it. Imaging studies in these patients indicated a midline anterior nasal sinus tract with cranial dilatation but no intracranial connection. They were successfully managed surgically. Conclusion: Nasofrontal dermoid sinus cysts have a unique embryological origin. A midline basal frontal dermoid associated with a dimple or sinus opening on the nasal dorsum with or without protruding hair and sebaceous discharge is the classical presentation. The purpose of this report is to emphasize that, though rare nasofrontal dermoid sinus cysts do occur in our practice and their clinical importance from rhinology point of view is their potential for intracranial communication.