Joaquin Hidalgo1, Richard J Redett2, Bruno P Soares3, Alan R Cohen4. 1. Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. 2. Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. 3. Department of Radiology, University of Vermont Medical Center, Burlington, VT, USA. 4. Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. alan.cohen@jhmi.edu.
Abstract
INTRODUCTION: Nasal dermoids with intracranial extension are benign lesions that can have life-threatening consequences, as a nasal punctum may serve as a portal of entry for infection into the central nervous system. The surgical management of these lesions can be challenging, as the extracranial and intracranial cysts and sinus tract must be resected to prevent recurrence, and the surgery must be carried out with an acceptable esthetic result. TECHNIQUE: The authors present a technique for the resection of nasocranial dermoids that eliminates the need to remove and replace the frontonasal segment. Working through a small frontal craniotomy enables the surgeon to drill out the sinus tract through the foramen cecum and inferiorly into the nose. This exposure eliminates the need to enter the frontal sinus, if it is present. CONCLUSION: The extracranial punctum and tract are resected from below in a minimally invasive fashion that permits removal of the lesion without a disfiguring scar.
INTRODUCTION: Nasal dermoids with intracranial extension are benign lesions that can have life-threatening consequences, as a nasal punctum may serve as a portal of entry for infection into the central nervous system. The surgical management of these lesions can be challenging, as the extracranial and intracranial cysts and sinus tract must be resected to prevent recurrence, and the surgery must be carried out with an acceptable esthetic result. TECHNIQUE: The authors present a technique for the resection of nasocranial dermoids that eliminates the need to remove and replace the frontonasal segment. Working through a small frontal craniotomy enables the surgeon to drill out the sinus tract through the foramen cecum and inferiorly into the nose. This exposure eliminates the need to enter the frontal sinus, if it is present. CONCLUSION: The extracranial punctum and tract are resected from below in a minimally invasive fashion that permits removal of the lesion without a disfiguring scar.
Entities:
Keywords:
Dermal sinus; Dermoid; Nasal lesions; Skull base