Main Theme: Rhinology
Introduction: Nasal dermoid sinus cysts (NDSCs) are rare congenital anomalies requiring surgical excision, with recurrence posing a significant clinical challenge. Outcomes vary significantly based on multiple factors, such as surgical approach, nature of lesion, prior infections and timing of surgery.
Methods: A retrospective review of 55 paediatric patients undergoing primary NDSC excision between 2012 and 2025 at a UK tertiary centre was conducted. Data on demographics, clinical presentation, extension of lesion, surgical approach, and recurrence were collected. Univariate analyses and multivariate logistic regression were employed to identify independent predictors of recurrence and a Kaplan-Meier curve assessed recurrence-free survival.
Results: The cohort comprised 55 patients (29 males, 26 females) with a mean age of 3.6 years (range: 0-15). The overall recurrence rate was 18.2% (10/55). The majority of recurrence events (90.0%) were identified within the first 24 months postoperatively. Multivariate analysis identified deep extension (intraosseous or intracranial) as a significant independent predictor of recurrence (OR: 10.16, p=0.015). Open rhinoplasty approach demonstrated a significantly increased risk (OR: 19.73, p=0.013). Preoperative infection or clinical presentation (cyst vs. sinus) were not found to be significantly associated with recurrence. Scar revision were required in 2(3.6%). The mean follow-up was 30.3 months (median: 20.1 months).
Conclusion: Deep extension and open rhinoplasty approach are significant independent predictors of recurrence in NDSCs. These findings underscore the importance of meticulous preoperative imaging to delineate lesion depth and careful selection of surgical approach to minimise recurrence risk. We recommend a minimum follow-up of 24 months.