Nasal dermoid cysts are rare congenital anomalies that may cause recurrent infections and have the potential for intracranial extension. In this case, a six-year-old boy presented with fever, nasal swelling, and periorbital oedema. A pit found on the nasal tip raised suspicion of a dermoid cyst. MRI confirmed a dermoid cyst and furthermore showed intracranial extension. Surgery was performed at a tertiary unit in a joint venture by ENT and neurosurgery teams. Dermoid cysts should be considered in recurrent nasal infections, especially if a pit is seen between the glabella and columella.

A 3-year-old male presented with a history of a nasal dermoid cyst with intracranial extension as well as a concomitant isolated intracranial dermoid cyst of the middle cranial fossa. Initially, at 2 years of age, he underwent successful transnasal endoscopic resection of an anterior skull base dermoid cyst. He then presented for a staged dermoid cyst resection of the right sphenoid bone at the lesser wing because of interval growth between imaging studies. A right-sided transorbital neuroendoscopic approach (TONES) was utilized for lesion resection. A gross-total resection was achieved, with no complications. Excellent neurological and cosmetic outcome was achieved. The video can be found here: https://stream.cadmore.media/r10.3171/2025.1.FOCVID24157.

A three-year-old boy was referred to our clinic for a draining lesion on the dorsum of the nose, several months following the surgical excision of a nasal dermoid cyst in Egypt. Physical examination demonstrated a pit on the skin of the nasal dorsum, and magnetic resonance imaging (MRI) was consistent with dermoid cyst recurrence. The patient underwent reoperation using a combined vertical incision and open rhinoplasty approach, with excellent pathologic and cosmetic results. Here, we present this case as a surgical approach to consider in the excision of nasal dermoid cysts.

Nasal dermoid cysts are rare congenital anomalies that can present with intracranial extension in approximately 10% of cases. Traditional surgical approaches require frontal craniotomy, which is invasive and may lead to significant morbidity. We describe a novel, minimally invasive, endoscopic-assisted surgical approach for the removal of a nasofrontal dermoid cyst with intracranial extradural extension. A 2-year-old girl with a nasal dermoid cyst extending intracranially was treated using an endoscopicassisted technique through a small skin incision. Surgical steps, intraoperative findings, and postoperative outcomes were recorded. The procedure allowed complete resection with excellent visualization, reduced morbidity, and satisfactory cosmetic outcomes. No cerebrospinal fluid leakage or recurrence was noted at 6-month follow-up. Endoscopic-assisted removal is a safe and effective alternative to traditional approaches, providing excellent tumor visualization and better cosmetic results while minimizing surgical morbidity.

Congenital nasal swellings are commonly encountered in pediatric practice. Differential diagnosis includes dermoid cyst, meningoencephalocele, glioma, benign tumors. Here we discuss 10 cases of nasal dermoid which were studied between January 2022 - December 2022 to obtain clinical data for diagnosis and treatment in pediatric population. In total 10 patients in the age group of 1-10 years were included, patients presented either with a swelling on nose or sinus opening on nose or a combination of the two. After radiological investigation, each patient was taken up for excision of sinus/cyst and 1year follow up was done for each. The objective of this article is to present few cases of nasal dermoid cyst sinus in pediatric patients and to discuss the embryology, clinical presentation, diagnosis and surgical approach of such lesions.