CONGENITAL NASAL DERMOID CYSTS AND FISTUL AS - REPORT OF 19 CASES

A series of 19 children with congenital nasal dermoid cyst or fistulas admitted in our department between 1978 and 1992 was reviewed in a re trospective study. They were 8 females and 11 males, ages ranged from 9 months to 7 years (mean: 2 years and 4 months). At diagnosis 8 child ren presented with infection (superficial in 6 cases, neurological in 2 cases), and in 11 cases the malformation was discovered by the famil y physician. In 14 cases the cyst was located at the mid nasal ridge. Four children had associated malformations : neurodevelopmental delay (2 cases), hypertelorism (I case) and external ear agenesia with facia l palsy. The cyst was subcutaneous in 5 cases and was operated on thro ugh a nasal approach. The 14 other children were operated through asso ciated intra and extracranial approaches. Surgical exploration disclos ed a dural extension of the fistula in 9 cases. When performed, preope rative radiological explorations including CT Scan and/or MRI had not always predicted the dural extension. The mean follow-up is 5,3 years. No recurrence was recorded and the cosmetic result was always excelle nt. Preoperative radiological investigations are necessary to precise the location of these malformations and to detect associated disorders , but they appear unable to prove the extension of the fistula to the dura. Intracranial and extracranial approaches should be always planne d to perform a total excision of the lesion.