Occipital dermal sinuses - Report of nine pediatric cases end review of the literature

Occipital dermal sinuses (ODS) are rare dysraphic lesions resulting from de fective separation of the ectoderm and neuroderm, These lesions are often d iagnosed at birth and should be treated early because of potentially life-t hreatening complications, However, the pathogenesis of these rare lesions i s still poorly understood, and there is no consensus about the optimal timi ng of surgery, We reviewed 9 pediatric cases of ODS operated in our departm ent since 1982 and 79 other cases published in the literature during the la st 50 years, Thirty-eight percent of these had neurological infection (meni ngitis or abscess), 22% had purely local infection and 40% were uncomplicat ed at the time of diagnosis, The incidence of infection was low during the first year of life. MRI was highly valuable to study the extent of the sinu s and the content of the cyst, The outcome was regularly favorable after su rgery, Surgery should however be undertaken with caution on account of the intimate relationship with venous structures, aggravated by postinfectious scarring when the patient is operated late. Considering the risks associate d with surgery in neonates acid the low incidence of infection during the f irst year, we advise performing surgery at around 6 months. Copyright (C) 2 001 S. Karger AG, Basel.