Nasal dermoid

Nasal dermoid

Overview

Nasal dermoids are rare congenital midline nasal masses that form as a result of aberrant migration of mesodermal and ectodermal cells during formation of nasal structures.

Pathophysiology

Epidemiology

Nasal dermoids make up approximately 10% of head and neck dermoids, and approximately 1% of all dermoids.

Diagnosis

Patient History

Nasal dermoids are congenital lesions, and should be identifiable from birth. Small dermoids may go unnoticed for some time. Important considerations include any other history of congenital malformations, known genetic syndromes, and history of nasal obstruction.

Physical Examination

Many dermoids have a sinus tract exiting the skin near the nasal dorsum in the midline. Dimples and fistula tracts may appear as high as the glabella or as inferior as the columella. In the presence of active infection, the underlying cyst cavity may be erythematous, tender to touch, or present with purulent drainage from a patent fistula tract. A widened nasal dorsum or hypertelorism may be present in large dermoids.

Differential Diagnosis

Other midline congenital nasal masses should be considered:

• Glioma
• Encephalocele