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Tumor Discovery

CASE REPORT
Columella fistula: A case report

Sara Moujrid*, Meriem Jabri, Walid Bijou , Youssef Oukessou , Sami Rouadi,
Redallah Abada, Mohamed Roubal, and Mohamed Mahtar
Department of ENT, Face and Neck Surgery, Faculty of Medicine and Pharmacy of Casablanca,
University of HASSAN 2, Casablanca, Morocco

Abstract

Cysts and fistulas located on the dorsum of the nose are rare occurrences. These
malformations are strictly confined to the midline, extending from the columella
to the glabella. In some cases, they may extend deeply, potentially reaching the
leptomeningeal spaces. Imaging studies are crucial for determining the depth of
extension and the relationship between the malformation and surrounding structures,
such as the cribriform plate and meninges. Detection of frontal and/or nasal bone
defects on computed tomography scans or the presence of a transosseous canal with or
without a cyst on magnetic resonance imaging should raise suspicion of a dermal sinus
cyst prompt surgical excision is indicated to mitigate the risk of the most concerning
complication: Neuro-meningeal superinfection. Preferably, surgical excision should be
carried out before the age of 1 year to minimize the risk of infection. If communication
with meningeal spaces is suspected, neurosurgical intervention becomes necessary.
Herein, we present the case of a 4-year-old male child with a history of neonatal
distress, psychomotor delays, and epileptic seizures. The patient presented a fistula at
the columella level, accompanied by pus discharge, within the context of dysmorphic
syndrome. Consequently, the patient was scheduled for fistula excision.
*Corresponding author:
Sara Moujrid
(saramoujrid9@gmail.com) Keywords: Columella fistula; Nasofrontal fistula; Nasal dermoid sinus cysts
Citation: Moujrid S, Jabri M,
Bijou W, et al. Columella fistula:
A case report. Tumor Discov.
2024;3(3):2566. 1. Background
doi: 10.36922/td.2566
Nasofrontal fistulas, also known as nasal dermoid sinus cysts (NDSCs), are very rare,
Received: December 29, 2023 occurring in 1/40000 to 1/20000 births. As a persistent entry point for infections, they
1,2
Accepted: April 19, 2024 are often revealed by locoregional and especially neuro-meningeal infections, making this
congenital malformation particularly serious. The most frequent types are dermoid cysts and
Published Online: July 4, 2024
fistulas, nasal gliomas, and encephaloceles. These anomalies result from congenital anomalies
Copyright: © 2024 Author(s). during embryonic development, usually appearing as masses along the midline of the nose,
This is an Open-Access article
distributed under the terms of the anywhere between the glabella and the columella. Patients are at risk of neuro-meningeal
Creative Commons Attribution infectious complications due to the possibility of an intracranial connection, hence the need
License, permitting distribution, for early surgical treatment. Neuroimaging techniques are essential for assessing the presence
and reproduction in any medium,
provided the original work is of intracranial extension. Herein, we report the case of a 4-year-old child with a history of
properly cited. psychomotor delay with dysmorphic syndrome, presenting with a columella fistula.
Publisher’s Note: AccScience
Publishing remains neutral with 2. Case presentation
regard to jurisdictional claims in
published maps and institutional In this case, the patient is a 4-year-old male child with a history of neonatal distress
affiliations. following a poorly followed pregnancy, along with psychomotor delays and epileptic

Volume 3 Issue 3 (2024) 1 doi: 10.36922/td.2566