Excision of nasal dermoids with intracranial extension—Anterior small window craniotomy approach

Update on current evaluation and management of pediatric nasal dermoid

“…Two of these patients underwent vertical excision and two medial paracanthal (Lynch) incisions. None had evidence of a sinus tract or intracranial extension, and none had recurrence at a mean follow-up of 8.5 years (range, [5][6][7][8][9][10][11][12].…”

“…However, in recent years both subcranial and endoscopic approaches have been proposed. These avoid the morbidity of frontal craniotomy, which may include meningitis, hyposmia, CSF leak, damage to the frontal and sagittal sinuses, intracerebral hemorrhage, cerebral edema, epilepsy, memory and concentration deficits, and osteomyelitis of the frontal bone …”

The external rhinoplasty approach for congenital nasal lesions in children

“…This requires the use of a spinal drain with the associated potential for complications. Recently a minimal frontal craniotomy via a gull wing incision has been advocated [10]. We would suggest that facial incisions like this, visible across the nose, are not required.…”

Endoscopic resection of intracranial dermoid cysts

“…6,9 Despite this, numerous authors have stated that dermoid cysts that extend intracranially into or past the falx cerebri cannot be resected endoscopically. 11 Others have suggested a 'keystone' approach, requiring a bifrontal craniotomy, as being the most effective at achieving total resection. 10 Some surgeons have found that a brow incision and small window craniotomy is a superior technique with less morbidity than a frontal craniotomy.…”

“…11 Many of these problems are minimised or eliminated when open excision is avoided. 11 Many of these problems are minimised or eliminated when open excision is avoided.…”