Dermoid cyst Nasal tip Excision

By

Dr. T. Balasubramanian M.S. D.L.O.

Synonyms: Dermoid cyst nose, Cysts of nose

Dermoid cysts of skin commonly occur mostly in face, neck or scalp.  It is actually a congenital inclusion cyst.  Dermoid cyst of external nose is a rare entity.  These are usually present at birth and gradually increase in size.  It occurs due to sequestration of skin along the lines of embryonal closure.  
These dermoid cysts are are lined by an epidermis that possesses various epidermal appendages.  These appendages are fully mature.  Hair follicles containing hairs that project into the lumen of the cyst are often present. The dermis of dermoid cysts usually contains sebaceous glands; eccrine glands; and, in many patients, apocrine glands.

This 16 year old boy presented with swelling over tip of nose since birth.  It was gradually increasing in size.  Since it was consmetically unacceptable for the patient he sought medical help.  He was taken up for surgery.

The surgery was performed under general anesthesia.




















Clinical photograph showing dermoid cyst over the tip of nose



The cyst was accessed through an inter cartilagenous incision.



















Diagram showing the various incisions used to expose the cyst





















Incision being put




The major advantage of this inter cartilagenous approach is a ghastly scar is avoided over the nose and face.  The surgery is cosmetically acceptable to the patient.

Complications:

Complications of surgery include:

1. Wound infection
2. Cartilage necrosis leading on to nasal deformity
3. Recurrence of the cyst if not completely removed