Hong S W
Mount Vernon Centre for Plastic Surgery, Northwood, Middlesex, UK.
Br J Plast Surg. 1998 Apr;51(3):255-7. doi: 10.1054/bjps.1997.0236.
The commonest location for dermoid cysts in the head and neck is at the frontotemporal or brow region. They usually present as discrete slow growing masses located superficially at the angle of the brow. The presentation as a discharging sinus in the frontotemporal region is rare. In contrast, it is common for nasal dermoids to present as sinuses or fistulae (10-45%) and with a tract extending deep to involve the underlying bone or intracranium. In view of their differences in presentation, preoperative CT scans are generally recommended for the nasal dermoids but not for the frontotemporal dermoids. We report a rare case of a deep frontotemporal dermoid cyst presenting as a discharging sinus at the right temporal region in a girl aged 2 years and 6 months. It had a sinus tract extending deep to form an intraosseous cyst in the frontal and sphenoid bone. The base of the cyst was attached to the dura of the middle cranial fossa. Only a few similar cases were reported in the literature. In the light of our experience with this case, we recommend that this rare type of frontotemporal cyst sinus be operated only after a CT or MRI scan.
头颈部皮样囊肿最常见的部位是额颞部或眉弓区域。它们通常表现为位于眉弓角浅表的孤立性缓慢生长肿块。在额颞部表现为有分泌物排出的窦道较为罕见。相比之下，鼻皮样囊肿常表现为窦道或瘘管（10% - 45%），且有一条深入延伸至下方骨质或颅内的管道。鉴于其表现不同，鼻皮样囊肿术前一般建议行CT扫描，而额颞部皮样囊肿则无需。我们报告一例罕见的深部额颞部皮样囊肿，发生于一名2岁6个月女童的右侧颞部，表现为有分泌物排出的窦道。它有一条深入延伸的窦道，在额骨和蝶骨内形成骨内囊肿。囊肿底部附着于中颅窝硬脑膜。文献中仅报道了少数类似病例。根据我们对该病例的经验，我们建议这种罕见类型的额颞部囊肿性窦道仅在CT或MRI扫描后进行手术。
