The presentation and management of nasal dermoid: a 30-year experience.

OBJECTIVE To review the presentation of nasal dermoid in children and present guidelines for its management. DESIGN Retrospective study (January 1, 1970, through December 31, 2000). SETTING Tertiary-care pediatric medical center. PATIENTS Number of patients: 42 (28 boys and 14 girls). Intervention Extensive review of the initial presentation, significant family and medical history, workup, surgical approach, complication, and rate of recurrence. RESULTS Mean age of presentation was 32 months. The most common presentation was a nasoglabellar mass, in 13 patients (31%). Five patients presented with an associated craniofacial abnormality. Thirty-nine patients (93%) underwent a preoperative imaging workup. Thirty-one (74%) did not show any clinical and/or radiographic indication of intracranial extension. Thirty-four (81%) underwent extracranial excision, and 8 (19%) underwent combined intracranial-extracranial excision. Five patients (12%) presented with recurrence, extracranially in 4 and intracranially in 1. No other complication was noted, with a mean follow-up of 7 years. CONCLUSIONS Nasal dermoid is a rare congenital anomaly. Preoperative evaluation is essential to rule out intracranial extension. Surgical strategy depends on the location and extent of the lesion, ranging from local excision to a combined intracranial-extracranial approach. Recurrence is uncommon and often easily managed.