The transglabellar subcranial approach for nasal dermoids with intracranial extension

Robert M Kellman, Parul Goyal, Gerard S Rodziewicz
Laryngoscope 2004, 114 (8): 1368-72

OBJECTIVES/HYPOTHESIS: Nasal dermoids are the most common congenital midline nasal lesions. When a midline nasal pit or cyst is identified, scans should be obtained to look for an intracranial connection. The intracranial portion of the lesions has traditionally been approached by the performance of a frontal craniotomy. The transglabellar subcranial approach is a useful technique to resect these lesions and offers several advantages over a traditional craniotomy approach.

STUDY DESIGN: Retrospective case review.

METHODS: Records of two patients who underwent excision of nasal dermoids by way of a subcranial approach were analyzed.

RESULTS: Two patients underwent successful resection of nasal dermoids with intracranial extension by way of a subcranial approach. The patients were 13 months and 19 months old at the time of excision and have been followed for 7 years and 6 years, respectively. There has not been any recurrence of the lesions. There has been no apparent negative impact on facial growth in either of these cases.

CONCLUSIONS: The subcranial approach is an effective technique for the resection of nasal dermoids with intracranial extension. These lesions have traditionally been managed with lateral rhinotomy, midface degloving, or external rhinoplasty approaches combined with a frontal craniotomy. The subcranial approach offers excellent exposure, minimizes frontal lobe retraction, reduces the likelihood of cerebrospinal fluid leak, and provides for excellent cosmetic result. This approach was used in two cases with long-term follow-up. The lesions were successfully resected in both cases. Long-term follow-up has shown no recurrence or negative effect on craniofacial growth.

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