Nasal dermoids without intracranial extension in teenagers.

BACKGROUND: Nasal dermoid cysts are benign, cystic midline masses. They contain mature tissues and often pocket hair, fat or sebum. Patients usually present with nasal enlargement or with a wide nasal dorsum with or without a fistula, causing an unacceptable cosmetic appearance. OBJECTIVE: To define a reliable surgical approach and method of removing dermoid with no intracranial extension in adolescent age. METHODS AND RESULTS: We retrospectively present diagnostic and therapeutic procedures in three teenagers ages 15, 17 and 18. All patients underwent prior surgeries at different hospitals. In the first case, the incision and exstirpation of the fistula's opening, followed by the fistula's canal, was performed. In the other two patients, the nasal dermoids were removed via the open approach with the transcollumelar incision. In all patients, we performed rhinoplasty with osteotomies to achieve an improved cosmetic effect. The esthetic results are presented. CONCLUSION: The diagnosis of nasal swelling requires imaging. Total excision of the cyst is considered the casual treatment. The open rhinoplasty is an adequate method in patients with nasal dermoids without an intracranial extension. Experienced surgeons should manage the functional and esthetical aspects together during the same surgery.