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Gasparella P, Singer G, Spendel S, Nagy E, Eder HG, Klaritsch P, Till H, Haxhija EQ. Nasal glial heterotopia: A rare interdisciplinary surgical challenge in newborns. LA PEDIATRIA MEDICA E CHIRURGICA 2021; 43. [PMID: 33876893 DOI: 10.4081/pmc.2021.240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 03/19/2021] [Indexed: 11/22/2022] Open
Abstract
Nasal Glioma (NG) represents a rare congenital abnormality of the neonate, which can be associated with skull defects or even a direct communication to the central nervous system. MRI serves valuable information for differentiation from encephalocele, dermoid cyst and congenital hemangioma. Complete resection remains the treatment of choice. We present two cases of NG, which were both suspected during prenatal ultrasound and MRI. In the first case, postnatal MRI showed a transcranial continuity. Mass excision was performed and the defect was covered by a glabellar flap allowing a good cosmetic result. Postnatal MRI excluded a trans-glabellar communication in the second case. After surgical excision, the resulting skin defect was covered with a full thickness skin graft harvested from the right groin. In cases of NGs complete resection and cosmetic appealing results can be achieved and might necessitate a multidisciplinary approach.
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Affiliation(s)
| | | | - Stephan Spendel
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery.
| | - Eszter Nagy
- Division of Pediatric Radiology, Department of Radiology.
| | | | - Philipp Klaritsch
- Department of Gynecology and Obstetrics, Medical University of Graz, Graz.
| | - Holger Till
- Department of Pediatric and Adolescent Surgery.
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Méndez-Gallart R, García-Palacios M, Carracedo-Reboredo R, Rodríguez-Barca P, Bautista-Casasnovas A. Diagnostic prénatal de gliome nasal chez un fœtus. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2018; 40:525-526. [DOI: 10.1016/j.jogc.2017.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Méndez-Gallart R, García-Palacios M, Carracedo-Reboredo R, Rodríguez-Barca P, Bautista-Casasnovas A. Prenatal Diagnosis of Fetal Nasal Glioma. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2017; 40:523-524. [PMID: 28483331 DOI: 10.1016/j.jogc.2017.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 01/22/2017] [Accepted: 02/01/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Roberto Méndez-Gallart
- Department of Pediatric Surgery, University Hospital of Santiago, Santiago de Compostela, A Coruña, Spain
| | - Maria García-Palacios
- Department of Pediatric Surgery, University Hospital of Santiago, Santiago de Compostela, A Coruña, Spain
| | | | - Pablo Rodríguez-Barca
- Department of Pediatric Surgery, University Hospital of Santiago, Santiago de Compostela, A Coruña, Spain
| | - Adolfo Bautista-Casasnovas
- Department of Pediatric Surgery, University Hospital of Santiago, Santiago de Compostela, A Coruña, Spain
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Lartizien R, Durand C, Blaise S, Morand B. Nasal glial heterotopia or congenital hemangioma? A case report. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:298-301. [PMID: 28391080 DOI: 10.1016/j.jormas.2017.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/30/2016] [Accepted: 03/29/2017] [Indexed: 02/05/2023]
Abstract
Nasal glial heterotopia (NGH) is a rare benign tumor of the median line. We describe the case of a child presenting a lateral nasal mass. The characteristics of the prenatal ultrasound and the postnatal clinical examination argued in favor of a congenital hemangioma (CH). The MRI performed at 6 weeks of life suggested glial heterotopia. This diagnosis was confirmed by the pathological analysis. Congenital hemangiomas and nasal glial heterotopies have similar clinical presentations. Prenatal ultrasound diagnosis between NGH and CH is difficult. Fetal MRI is not yet highly specific for these two lesions, but it can eliminate an intracerebral connection in cases of NGH. Postnatal exams are more specific. Flow on the Doppler exam is rapid for CH and slow for NGH. On MRI, these two lesions appear as a hypersignal on T2-weighted sequences, but less intense for NGH than for CH. Distinguishing between NGH and CH can be difficult. This does not have a direct incidence on treatment because it is surgical in both cases.
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Affiliation(s)
- R Lartizien
- Grenoble University Hospital, Department of Maxillo-facial Surgery, Avenue Maquis du Grésivaudan, 38700 La Tronche, France.
| | - C Durand
- Grenoble University Hospital, Department of Pediatric Radiology, Avenue Maquis du Grésivaudan, 38700 La Tronche, France
| | - S Blaise
- Grenoble University Hospital, Department of Vascular Medicine, Avenue Maquis du Grésivaudan, 38700 La Tronche, France
| | - B Morand
- Grenoble University Hospital, Department of Maxillo-facial Surgery, Avenue Maquis du Grésivaudan, 38700 La Tronche, France
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Tonni G, Granese R, Martins Santana EF, Parise Filho JP, Bottura I, Borges Peixoto A, Giacobbe A, Azzerboni A, Araujo Júnior E. Prenatally diagnosed fetal tumors of the head and neck: a systematic review with antenatal and postnatal outcomes over the past 20 years. J Perinat Med 2017; 45:149-165. [PMID: 27508950 DOI: 10.1515/jpm-2016-0074] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 06/19/2016] [Indexed: 12/19/2022]
Abstract
AIM The aim of this study was to review prenatally diagnosed tumors of the head and neck in the fetus and to report antenatal and postnatal outcomes. METHODS PubMed/Medline, EMBASE/SCOPUS, Cochrane database and Google Scholar were reviewed over the last 20 years. No language or article type restriction was used. RESULTS A total of 1940 record were retrieved. Of the 713 records screened, 566 full-text articles were assessed for eligibility. After 445 articles were excluded for specified reasons, 111 studies met the research criteria and were included for qualitative analysis. Overall, 306 cases of fetal tumors of the head and neck were reviewed. Maternal age was an independent factor. The mean maternal age was 28.2 years and gestational age at prenatal diagnosis was 27.1 weeks. Conventional 2D ultrasound was the standard diagnostic procedure in 27.9% of cases and was implemented in 27.3% of cases by 3D ultrasound and fetal magnetic resonance imaging (MRI). Diagnostic evaluation of intracranial spreading and high-airway obstructions was greatly enhanced by fetal MRI. The more common type of fetal tumor was hemangioma/lymphangioms (42.1%), followed by teratomas (29.7%), tumors of the gingiva (10.1%) and lymphatic venous malformations (9.1%), respectively. Fetal karyotyping was performed only in 9.8% of cases; within fetuses undergoing karyotype, chromosomal abnormalities accounted for 20% of cases. The most common pregnancy complication was polyhydramnios (26.3%). Ex utero intrapartum treatment (EXIT) procedure was performed in 30.1% of cases while surgical excision was used in 22.9% during postnatal life. The survival rate was 35.35%. CONCLUSION Fetal tumors of the head and neck are rare congenital malformations. Two-dimensional ultrasound is diagnostic in almost all cases; however, MRI may be an important diagnostic adjunct in targeted cases and help patient selection for immediate intubation at the time of delivery. EXIT procedure and surgical removal of the tumor was associated with good prognosis.
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Abstract
Nasal dermoids, encephaloceles, and gliomas are rare congenital lesions that result from improper embryologic development. The differentiation between them and a firm understanding of their pathology is necessary to avoid unnecessary complications. In view of their potential intracranial connection, prompt diagnosis and treatment are paramount. The authors review the embryology, diagnoses, radiologic work-up, surgical management, and complications of these midline craniofacial masses in children.
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Affiliation(s)
- Renae D Van Wyhe
- Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
| | - Edward S Chamata
- Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
| | - Larry H Hollier
- Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
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Boyer AC, Krishnan A, Goncalves LF, Williams L, Chaiyasate K. Prenatal Diagnosis of Nasal Glioma Associated with Metopic Craniosynostosis: Case Report and Review of the Literature. J Radiol Case Rep 2015; 9:1-8. [PMID: 26622922 DOI: 10.3941/jrcr.v9i4.2179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Nasal gliomas (nasal glial heterotopia) are rare benign congenital frontonasal lesions occurring in approximately 1:20.000-40,000 live births. The diagnosis is rarely reported prenatally. Nasal gliomas are typically isolated lesions, with syndromic association being exceedingly rare. Metopic craniosynostosis can occur as an isolated abnormality or in association with multiple syndromes. This case is the first reported case of nasal glioma in association with craniosynostosis in the published literature.
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Affiliation(s)
- Andrew C Boyer
- Department of Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA
| | - Anant Krishnan
- Department of Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA
| | - Luis F Goncalves
- Department of Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA ; Department of Obstetrics & Gynecology, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA
| | - Lindsay Williams
- Department of Pathology, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA
| | - Kongkrit Chaiyasate
- Department of Plastic and Reconstructive Surgery, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA
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Fox R, Okhovat S, Beegun I. Prenatal diagnosis and management of nasal glioma. World J Otorhinolaryngol 2014; 4:12-16. [DOI: 10.5319/wjo.v4.i3.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 06/10/2014] [Accepted: 07/14/2014] [Indexed: 02/06/2023] Open
Abstract
Advances in foetal imaging have increased our detection rate of craniofacial abnormalities in utero. Nasal glioma is a rare, benign, congenital facial defect. Once detected, further imaging is required to assess for intracranial communication, the presence of additional defects, determine the patency of the aerodigestive tract and decide on timing of delivery. The authors review the current literature on diagnosis and management of nasal glioma in this rapidly advancing field of craniofacial anomalies detected in utero. Literature search of EMBASE and MEDLINE databases yielded 594 articles, which were screened by 2 independent reviewers. A total of 7 papers were selected after exclusion. There have been seven cases of prenatally diagnosed nasal glioma. The earliest of these was detected at 20 wk gestation. The majority were investigated with foetal magnetic resonance imaging (MRI) to establish any intracranial communication or bony defects. Ultrasound monitoring, doppler waveform and 3D rendered images were utilised to delineate the lesion, monitor growth and differentiate potential diagnosis. Postnatal MRI is favoured by most to re-evaluate the lesion and aid surgical planning. Surgical resection was performed within the first few months of life. Diagnostic uncertainty was seen in all cases, until formal histology was obtained, emphasising the challenges, and need for early appropriate specialist input. Whilst the prenatal detection of craniofacial abnormalities increases, there remain diagnostic challenges in differentiating prenatal congenital midfacial defects in utero. These defects are best investigated and monitored using prenatal ultrasound and MRI, to narrow the differential diagnosis, guide timing of delivery and allow for appropriate surgical planning. Prenatally detected nasal glioma, may only be confirmed on histology and families must be counselled appropriately to prepare them for the possible alternative diagnoses. Early surgical resection was undertaken to achieve more favourable aesthetic outcomes, reduce complications of ocular development and provide definitive histological diagnosis.
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Prenatal detection and postnatal management of an intranasal glioma. J Pediatr Surg 2012; 47:1951-4. [PMID: 23084215 DOI: 10.1016/j.jpedsurg.2012.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 06/08/2012] [Indexed: 12/13/2022]
Abstract
Nasal gliomas are rare benign congenital midline tumors composed of heterotopic neuroglial tissue. They have potential for intracranial extension through a bony defect in the skull base. Neuroimaging is essential for identifying nasal lesions and for determining their exact location and any possible intracranial extension. Computed tomography is often the initial imaging study obtained because it provides good visualization of the bony landmarks of the skull base; it is not, however, well suited for soft tissue imaging. Magnetic resonance imaging has better soft tissue resolution and may be the best initial study in patients seen early in life because the anterior skull base consists of an unossified cartilage and may falsely appear as if there is a bony dehiscence on computed tomography. A frontal craniotomy approach is recommended if intracranial extension is identified, followed by a transnasal endoscopic approach for intranasal glioma. A case is presented of a huge fetal facial mass that was shown by ultrasound that protruded through the left nostril at 33 weeks of gestation. Computed tomography of the neonate suggested a transethmoidal encephalocele. Magnetic resonance imaging showed a huge mass occupying the nasopharynx and the nasal cavity and protruding externally to the face but ruled out bony discontinuity in the skull base and, therefore, any intracranial connection. The infant underwent an endoscopic resection of the mass via oral and nasal routes and pathologic examination revealed intranasal glioma.
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Tonni G, Rosignoli L, Centini G, Lituania M, Doneda C. Three-Dimensional Sonography, Tomographic Sonography Imaging, and the OmniView Algorithm. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2012. [DOI: 10.1177/8756479312439121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The prenatal diagnosis of congenital dacryocystocele has been reported using 2D sonographic imaging, but there are very few reports of the use of 3D sonography for this diagnosis. Two cases are presented in which 3D and Doppler sonography was helpful in determining the prenatal diagnosis. The embryologic basis of this obstruction of the nasolacrimal duct is discussed along with techniques for the prenatal diagnosis, including the potential value of 3D sonography in limiting the necessity of other prenatal testing. The importance of establishing the differential diagnosis is also discussed, as there is the possibility of the dacryocystocele being secondary to a sinonasal tumor.
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Affiliation(s)
- Gabriele Tonni
- Prenatal Diagnostic Service, Division of Obstetrics & Gynecology, Guastalla Civil Hospital, AUSL Reggio Emilia, Italy
| | | | | | - Mario Lituania
- Preconceptional and Prenatal Physiopathology Service, Galliera Hospital, Genoa, Italy
| | - Chiara Doneda
- Istituti Clinici di Perfezionamento, Ospedale del Bambino “V. Buzzi”
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Beegun I, Dua R, Connor S, Bentley R. Prenatal diagnosis and management of a craniofacial glioma detected at 20 weeks' gestation. Case report and review of the literature. Int J Oral Maxillofac Surg 2011; 41:200-2. [PMID: 22137638 DOI: 10.1016/j.ijom.2011.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 10/30/2011] [Accepted: 11/08/2011] [Indexed: 12/31/2022]
Abstract
Foetal imaging and anomaly detection is advancing at a rapid rate. As a result, detection of foetal craniofacial abnormalities is increasing. Ultrasound and magnetic resonance imaging are currently the imaging modalities most commonly used. The authors describe the detection of a nasal glioma at 20 weeks' gestation, subsequent prenatal monitoring and postnatal management with surgical excision at 2 months of age. The world literature regarding prenatal diagnosis and management of craniofacial malformations is discussed.
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Affiliation(s)
- I Beegun
- Department of Oral & Maxillofacial Surgery, Kings College University Hospital, UK.
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Ajose-Popoola O, Lin HW, Silvera VM, Teot LA, Madsen JR, Meara JG, Rahbar R. Nasal glioma: prenatal diagnosis and multidisciplinary surgical approach. SKULL BASE REPORTS 2011; 1:83-8. [PMID: 23984207 PMCID: PMC3743595 DOI: 10.1055/s-0031-1284210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 04/22/2011] [Indexed: 11/01/2022]
Abstract
Nasal gliomas are congenital, nonmalignant rests of neuroglial tissue that typically present as a craniofacial mass. The differential diagnosis of such masses includes lesions that often require the involvement of various surgical subspecialties, including otolaryngology, neurosurgery, plastic surgery, and ophthalmology. Early surgical excision of these masses is advised to minimize nasal and craniofacial distortion. Accordingly, early diagnosis and management planning are paramount, and advances in prenatal imaging are creating a new role for obstetricians and radiologists in the initiation of diagnostic and therapeutic interventions. We describe the case history of a young patient found to have a craniofacial mass on routine prenatal ultrasound and subsequently managed with a multidisciplinary team approach.
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Tonni G, Lituania M, Bonasoni MP, De Felice C. Prenatal ultrasound and histological diagnosis of fetal nasal glioma (heterotopic central nervous system tissue): report of a new case and review of the literature. Arch Gynecol Obstet 2011; 283 Suppl 1:55-9. [PMID: 21331541 DOI: 10.1007/s00404-011-1856-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2010] [Accepted: 02/03/2011] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Nasal glioma is a rare, benign congenital midline facial lesion. MATERIALS AND METHODS Prenatal ultrasound diagnosis performed at 2nd trimester of pregnancy revealed a right-sided mass at the level of the fetal face extending from the right internal canthus to the nasal bridge. CONCLUSION Differential diagnosis of facial mass in the fetus represents a critical issue because is essential in guiding the prenatal counselling of the couple and in guiding the prenatal and/or postnatal management. Alternative diagnoses such as dacryocystocele, dermoid cyst, retinoblastoma or teratoma, hemangioma, and encephalocele that can not completely be excluded prenatally are discussed. Embryology, pathology, prenatal ultrasound diagnostic clusters of the lesion as well as MR imaging findings are discussed together with review of the literature.
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Affiliation(s)
- Gabriele Tonni
- Prenatal Diagnostic Service, Guastalla Civil Hospital, AUSL Reggio Emilia, Via Donatori Sangue, 1, 42016, Guastalla, Reggio Emilia, Italy.
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Grzegorczyk V, Brasseur-Daudruy M, Labadie G, Cellier C, Verspyck E. Prenatal diagnosis of a nasal glioma. Pediatr Radiol 2010; 40:1706-9. [PMID: 20401478 DOI: 10.1007/s00247-010-1642-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2009] [Revised: 01/25/2010] [Accepted: 02/07/2010] [Indexed: 12/14/2022]
Abstract
Nasal glioma is a rare congenital midline malformation composed of heterotopic masses of neuroglial tissue. We report a case of fetal nasal glioma diagnosed by sonography at 22 weeks' gestation as a vascular hypoechoic mass located on the left nasal bone. Fetal MRI excluded an underlying bone defect. At birth, the lesion appeared as a reddish mass. Post natal imaging confirmed the vascularisation within the lesion with an arterial low-flow velocity and a high-resistance spectrum, consistent with a glioma. The child underwent surgery at 5 months and final diagnosis was made on pathological examination. Therefore, a vascular lesion and a clinical aspect mimicking a haemangioma should not be considered sufficient to reach the final diagnosis.
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Affiliation(s)
- Véronica Grzegorczyk
- Department of Obstetrics and Gynaecology, Rouen University Hospital, Rouen, France
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