A 5-year-old child presents with a midline nasal dorsum mass present since birth. MRI shows a tract extending to the foramen caecum without intracranial extension. What is the most appropriate management?
- A Surgical excision via external rhinoplasty approach with possible osteotomy if tract extends posteriorly ✓
- B Biopsy of the external mass to confirm diagnosis
- C Observation until age 10 years
- D Intralesional steroid injection
Correct answer: A. Surgical excision via external rhinoplasty approach with possible osteotomy if tract extends posteriorly
Explanation
Nasal dermoid sinus cysts are congenital midline lesions that occur when the dural projections through the foramen caecum fail to regress. They can have a sinus opening on the nasal skin and a tract extending to the foramen caecum. Preoperative MRI is mandatory to rule out intracranial extension. Surgical excision is required to prevent infection and recurrence. Biopsy of the external opening is avoided as it may introduce infection into the tract.
Reference: Scott-Brown's Otorhinolaryngology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.