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Zhang J, Li Z, Pang P. Congenital Upper Lip Sinus. J Craniofac Surg 2024:00001665-990000000-01478. [PMID: 38688013 DOI: 10.1097/scs.0000000000010138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/07/2024] [Indexed: 05/02/2024] Open
Abstract
Congenital upper lip sinus (CULS) is an extremely rare anomaly. The aim of the study is to present a new case and compile the present knowledge of CULS to help foster a deeper understanding of this disease. A 9-year-old girl with a midline CULS, a prolonged maxillary labial frenulum, and a palatal epulis is presented. Thirty-nine papers met the eligibility criteria and 45 cases were included in the systematic review. CULS shows typical clinical and pathologic characteristics. It tends to occur at the midline region horizontally (n=35; 78%) and the upper part of the white lip (n=23; 51%) vertically. No ethnic predilection is found, but it tends to show a female predilection (n=28; 62%). Twenty-six cases (58%) are symptomatic. Thirteen cases (29%) are accompanied by other maxillofacial defects. In all cases, the sinus was lined with stratified squamous epithelium. The etiology remains unknown but 3 theories have been put forward: the fusion theory, the merging theory, and the invagination theory. The authors believe that CULS shows homogeneity with cleft lip to some extent and maybe a microform of it. Primary treatment is surgical excision and the prognosis is favorable, with no complications or recurrence.
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Affiliation(s)
- Jiarui Zhang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China
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Broad, Recurrent Nasal Dermoid Cyst: A Challenging Task. J Craniofac Surg 2021; 31:e760-e761. [PMID: 33136903 DOI: 10.1097/scs.0000000000006683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Nasal dermoid sinus cyst is a rare congenital midline anomaly. The embryological origin is different from the dermoid cysts seen in other parts of the face. Nasal dermoid sinus cysts constitute 1% to 3% of all dermoid cysts and 11% to 12% of head and neck dermoid cysts. While most lesions are detected in the first 3 years, in some cases they may not be noticed until later years. Delay in diagnosis increases recurrent infections, airway obstruction and intracranial complications. The authors present a 34-year-old patient with a broad nasal dermoid cyst who had previously undergone external rhinoplasty for a nasal dermoid cyst but relapsed after 5 months.
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Donnell CC, McKeague KF, Cooper A, Stenhouse J. Nasofrontal dermoid cyst: rare presentation of a philtrum sinus. Br J Oral Maxillofac Surg 2020; 58:608-610. [PMID: 32201047 DOI: 10.1016/j.bjoms.2020.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 03/02/2020] [Indexed: 11/28/2022]
Abstract
Congenital midline nasal lesions are extremely rare, and nasal dermoids are their most common presentation. To the best of our knowledge, only two cases of a philtrum sinus with skull base extension have been reported previously. A 3-year-old boy presented to the maxillofacial department with a discharging upper lip sinus that had been present from birth. No other congenital abnormalities were reported. Initially this sinus was assumed to be blind-ended and excised under general anaesthetic, but the area then failed to heal. Radiological work-up showed a patent dermal sinus that extended from the infranasal region through the nasal septum into the basal aspect of the anterior cranial fossa. The patient was referred for multidisciplinary management. A high index of suspicion of nasofrontal dermoid should be exercised when a patient presents with an upper lip sinus and recurrent discharge, until it is proven otherwise.
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Affiliation(s)
| | - Kelly F McKeague
- School of Dentistry, Belfast Health and Social Care Trust, United Kingdom
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Abstract
RATIONALE Nasal dermoid cysts are rare congenital lesions and may present as a midline nasal swelling. Nasal dermoid cysts usually present at birth and are commonly diagnosed by 3 years of age. An incidentally detected nasal dermoid cyst in an adult patient is extremely rare. PATIENT CONCERN We report an unusual case of an adult patient with an incidentally diagnosed dermoid cyst of the nasal septum, which presented as a longstanding discharging pit in the nasal columella since childhood. DIAGNOSIS A preoperative diagnosis of dermoid cyst of the nasal septum was made. INTERVENTION We performed the external rhinoplasty incision, including a small elliptical incision for removal of the columella pit. OUTCOME There has been no evidence of recurrence during the 2-year follow-up. LESSONS An incidentally detected nasal dermoid cyst in an adult patient is extremely rare. The most important point for the preoperative diagnosis of nasal dermoid cysts is to identify the presence or absence of intracranial extension. The treatment of choice for nasal dermoid cysts is complete surgical excision with clear margins.
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Kün-Darbois JD, Chatellier A, Paré A, Caillot A, Ambroise B, Bénateau H, Veyssière A. Congenital Midline Upper Lip Sinuses. Cleft Palate Craniofac J 2017; 55:292-295. [DOI: 10.1177/1055665617723635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Congenital sinuses of the upper lip are rare congenital malformations. There have been only 40 cases described in the literature. We report 3 cases of congenital midline upper lip sinus in Caucasian children. Two of those lesions were associated with other anomalies (complete cleft palate and hemifacial macrosomia or submucous cleft palate with bifid uvula). The pathophysiology remains unexplained yet. Congenital upper lip sinuses can be considered as possible microforms of cleft-lips. Associated anomalies are frequent and must be sought. The treatment is a full excision of the sinus tract and of the skin around the punctum in order to avoid risks of recurrence.
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Affiliation(s)
- Jean-Daniel Kün-Darbois
- Department of Maxillofacial and Plastic Surgery, Caen University Hospital, Caen, France
- GEROM research unit, Angers, University Hospital, Angers, France
| | - Anne Chatellier
- Department of Maxillofacial and Plastic Surgery, Caen University Hospital, Caen, France
| | - Arnaud Paré
- Department of Maxillofacial and Plastic Surgery, Tours University Hospital, Tours, France
| | - Aude Caillot
- Department of Maxillofacial and Plastic Surgery, Caen University Hospital, Caen, France
| | - Béatrice Ambroise
- Department of Maxillofacial and Plastic Surgery, Caen University Hospital, Caen, France
| | - Hervé Bénateau
- Department of Maxillofacial and Plastic Surgery, Caen University Hospital, Caen, France
- Maxillo-facial surgery, Medecine faculty of Caen, University of Caen Basse-Normandie, Caen, France
| | - Alexis Veyssière
- Department of Maxillofacial and Plastic Surgery, Caen University Hospital, Caen, France
- Laboratory EA 4652 Microenvironnement Cellulaire et Pathologies, BioconnecT team, Medecine faculty of Caen, University of Caen Basse-Normandie, Caen, France
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Kwok MMK, Paddle P. Median philtrum sinus: a rare presentation and review of management options. BMJ Case Rep 2017; 2017:bcr-2017-219779. [PMID: 28473432 DOI: 10.1136/bcr-2017-219779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Nasal dermoids are rare congenital abnormalities, and there is only one previously reported case of a philtrum sinus tract extending to the skull base. A 2-month-old boy was presented with an incidental finding of a median philtrum sinus with no infective features and no other abnormal clinical findings. MRI demonstrated a sinus tract extending from the philtrum to the crista galli. On multidisciplinary review, a conservative approach was taken due to the asymptomatic nature of the patient. Given the rarity of nasal dermoids, diagnosis requires precise clinical examination and MRI to identify the extent of the tract. Management options require a multidisciplinary case-specific approach and include non-surgical as well as surgical approaches.
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Affiliation(s)
- Matthew Ming Kei Kwok
- Otolaryngology, Head and Neck Surgery, Monash Health, Bentleigh East, Victoria, Australia
| | - Paul Paddle
- Otolaryngology, Head and Neck Surgery, Monash Health, Bentleigh East, Victoria, Australia.,Surgery, Monash University, Clayton, Victoria, Australia
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Rohart J, Nicot R, Myon L, Elbaz J, Raoul G, Ferri J. [Labial recurrent swelling revealing median congenital upper-lip fistula]. ACTA ACUST UNITED AC 2015; 116:315-9. [PMID: 26138739 DOI: 10.1016/j.revsto.2015.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 04/16/2015] [Accepted: 04/27/2015] [Indexed: 11/16/2022]
Abstract
Midline upper-lip fistulas are an extremely rare variant of congenital facial malformations. Less than 30 cases have been reported in the literature since 1970. We report the case of a 2 and a half-year-old girl presenting with a median congenital blind fistula of the upper lip, without any relation with the oral cavity. A recurrent swelling of the upper lip was the main symptom. Complete surgical excision of the cyst or of the fistulous tract must be obtained to avoid recurrence.
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Affiliation(s)
- J Rohart
- Département universitaire de chirurgie maxillofaciale et stomatologie, hôpital Roger Salengro, CHU de Lille, 59000 Lille, France; UDSL, université Lille Nord de France, 59000 Lille, France.
| | - R Nicot
- Département universitaire de chirurgie maxillofaciale et stomatologie, hôpital Roger Salengro, CHU de Lille, 59000 Lille, France; UDSL, université Lille Nord de France, 59000 Lille, France
| | - L Myon
- Département universitaire de chirurgie maxillofaciale et stomatologie, hôpital Roger Salengro, CHU de Lille, 59000 Lille, France
| | - J Elbaz
- Département universitaire de chirurgie maxillofaciale et stomatologie, hôpital Roger Salengro, CHU de Lille, 59000 Lille, France
| | - G Raoul
- Département universitaire de chirurgie maxillofaciale et stomatologie, hôpital Roger Salengro, CHU de Lille, 59000 Lille, France; UDSL, université Lille Nord de France, 59000 Lille, France; Unité Inserm U1008, médicaments et biomatériaux à libération contrôlée, 59000 Lille, France; Association internationale de médecine orale et maxillo-faciale (AIMOM), 7 bis, rue de la Créativité, 59650 Villeneuve-d'Ascq, France
| | - J Ferri
- Département universitaire de chirurgie maxillofaciale et stomatologie, hôpital Roger Salengro, CHU de Lille, 59000 Lille, France; UDSL, université Lille Nord de France, 59000 Lille, France; Unité Inserm U1008, médicaments et biomatériaux à libération contrôlée, 59000 Lille, France; Association internationale de médecine orale et maxillo-faciale (AIMOM), 7 bis, rue de la Créativité, 59650 Villeneuve-d'Ascq, France
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Bakshi SS, Kiruba Shankar M, Gopalakrishnan S. Midline upper lip sinus: a case report and review of literature. Oral Maxillofac Surg 2015; 19:217-219. [PMID: 25572979 DOI: 10.1007/s10006-014-0481-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 12/28/2014] [Indexed: 06/04/2023]
Abstract
PURPOSE A multitude of developmental anomalies has been reported in the head and neck, especially on the face; however, cases of upper lip sinuses and fistulas have hardly been reported. METHOD A 10-year-old girl presented with a recurrently discharging upper lip sinus. After adequate presurgical workup, excision of the lesion resulted in a clinical cure. RESULT Literature review suggests a number of theories for the origin of the upper lip sinus; however, none have proven to be conclusive. CONCLUSION Upper lip sinus formations are rare developmental events, and the pathogenesis of these lesions still needs further evaluation.
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Affiliation(s)
- Satvinder Singh Bakshi
- Department of ENT and Head & Neck Surgery, Mahatma Gandhi Medical College & Research Institute, Pillaiyarkuppam, Pondicherry, 607402, India,
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