Resection of intracranial nasal dermoid sinus cyst by endoscopic-assisted open rhinoplasty approach

Background: Nasal dermoid sinus cysts (NDSC) are infrequent congenital midline lesions. Complete removal is the treatment of choice. When there is intracranial involvement, the traditional surgical approach requires a bicoronal flap and frontal craniotomy. Case report: A 17-year-old male presented with a midline nasal dorsum mass. The radiological exams revealed a cystic lesion within nasal dorsum with intracranial extension through a patent foramen caecum into a bifid crista galli. Total macroscopic resection was performed through an endoscopic-assisted open rhinoplasty approach. The patient remains asymptomatic and free of recurrence after 20 months follow-up. Conclusion: This case demonstrates the feasibility of an endoscopic-assisted open rhinoplasty approach for successful resection of NDSC, avoiding a frontal craniotomy and the significant morbidity associated herewith.