The transglabellar subcranial approach for nasal dermoids with intracranial extension.
OBJECTIVE
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.


METHODS
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.
Kellman
Robert M
RM
Department of Otolaryngology--Head and Neck Surgery, Upstate Medical University, Syracuse, NY 13210, USA. kellmanr@upstate.edu
Goyal
Parul
P
Rodziewicz
Gerard S
GS
D003399:Craniotomy; D003884:Dermoid Cyst / Q000151:congenital* / Q000473:pathology / Q000601:surgery*; D004388:Dura Mater / Q000473:pathology / Q000601:surgery; D005624:Frontal Bone / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D009295:Nasal Bone / Q000601:surgery; D009361:Neoplasm Invasiveness; D009669:Nose Neoplasms / Q000151:congenital* / Q000473:pathology / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D012189:Retrospective Studies