Page 113 - TD-3-3

Tumor Discovery Columella fistula

most proximal part often consists of a fibrous tract or stem, a Writing – original draft: Sara Moujrid, Meriem Jabri
finding confirmed by histological assessment. MRI provides Writing – review & editing: Walid Bijou, Youssef Oukessou,
additional details regarding the relationship of the lesion to Sami Rouadi, Redallah Abada, Mohamed Roubal,
the spinal parenchyma and dura mater. 1,2,6,12,13 Mohamed Mahtar
However, a definitive diagnosis of the lesion’s Ethics approval and consent to participate
relationship with endocranial structures can only be
established through surgical exploration. During surgery, Not applicable.
fibrous tracts in contact with the dura may be observed,
though the relationship between the lesion and the dura Consent for publication
may not be clearly demonstrated. 7,13 We obtained a verbal agreement from the patient to
Various surgical approaches have been suggested in publish his case for scientific purposes while maintaining
different studies for the treatment of NDSCs. Achieving his anonymity. After obtaining the patient’s agreement
radical treatment requires exposure of the proximal end to publish his case as a clinical case in a journal, we
of the fistula. The simplest approach to access the foramen emphasized the importance of protecting his identity and
cecum and crista galli is a vertical incision. However, it is maintaining his anonymity.
crucial to consider that facial skin growth may influence Availability of data
scar formation despite correct skin incisions. In addition,
the risk of recurrent and serious pre-operative fistula Data used in this work is available from the corresponding
infection exists, which can result in visible scarring. 12,13 author upon reasonable request.
Another surgical approach involves exposing the References
dorsum of the nose and the foramen cecum through a
coronal transfrontal approach, as proposed by Kellman 1. Zheng Y, Ye B, Lv J, Xiang M. Progress of the diagnosis
and treatment of congenital nasal dermoid sinus cysts.
et al. Their study recommends a coronal approach with Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi.
8
frontal bone osteotomy. The subcranial approach provides 2021;35(2):176180.
excellent exposure, minimizes frontal lobe retraction,
reduces the risk of cerebrospinal fluid leak, and achieves doi: 10.13201/j.issn.2096-7993.2021.02.020
excellent cosmetic results. 13-15 2. Holzmann D, Huisman TA, Holzmann P, Stoeckli SJ.
Surgical approaches for nasal dermal sinus cysts. Rhinology.
4. Conclusion 2007;45(1):3135.
NDSCs should be considered in children presenting with a 3. Fernández Pérez AJ, Burgos Sánchez AJ, Gras Albert JR.
nasal or nasofrontal cutaneous disruption from the glabella Congenital lesions of the naso-frontal midline. Acta
to the columella, with or without fluid discharge. Similarly, Otorrinolaringol Esp. 2001;52(5):404408.
the presence of a frontal and/or nasal bone defect on CT doi: 10.1016/s0001-6519(01)78227-1
scans or a transosseous canal with or without a cyst on 4. Bigorre M. Kystes et fistules congénitaux de l’enfant. Ann
MRI should raise suspicion of dermal sinus cysts Prompt Chir Plast Esthét. 2016;61(5):37188.
surgical excision is indicated to avoid the most dreaded
complication: neuro-meningeal superinfection. doi: 10.1016/j.anplas.2016.07.010
5. Posnick JC, Bortoluzzi P, Armstrong DC, Drake JM.
Acknowledgments Intracranial nasal dermoid sinus cysts: Computed
tomographic scan findings and surgical results. Plast
None.
Reconstr Surg. 1994;93(4):745754, discussion 755-756.
Funding 6. Sessions RB. Nasal dermal sinuses--new concepts and
explanations. Laryngoscope. 1982;92(8 Pt 2 Suppl 29):128.
None.
doi: 10.1288/00005537-198208001-00001
Conflict of interest 7. Morimoto K, Takemoto O, Nishikawa M, Umegaki M,

The authors declare that they have no competing interests. Nishino A. Nasal dermal sinus with a dermoid cyst. Pediatr
Neurosurg. 2002;36(4):218219.
Author contributions doi: 10.1159/000056060

Conceptualization: Sara Moujrid 8. Kellman RM, Goyal P, Rodziewicz GS. The transglabellar
Investigation: Sara Moujrid subcranial approach for nasal dermoids with intracranial

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