Multiple lateral sinus pericranii: A case report

Introduction. Sinus pericranii is a rare vascular anomaly. It is characterized by abnormal communication between the extracranial and intracranial venous system, usually involving the superior sagittal sinus and occasionally the transverse sinus. Off the midline lesions are extremely rare. Multiplicity, associated venous lakes, venous angioma and lateral location are unusual and unique presentation of sinus pericranii. Case report. A case of multiple congenital off-midline sinus pericranii in the left frontotemporal and parietal region is presented. Magnetic resonance imaging showed an extracranial vascular anomaly connected with the intracranial venous system through abnormal diploic or emissary veins. The lesions were removed completely by surgery. Conclusion. Sinus pericranii is a rare vascular malformation with unique clinical and radiological features. Sinus pericranii may cause fatal complications, and it must be treated by surgical or endovascular procedures.

Our Experiences with Congenital Midline Nasal Dermoid Sinus Cyst

ABSTRACT Introduction Nasofrontal dermoid sinus cysts (NDSC) are rare congenital malformations. NDSCs are distinct from other facial dermoids in their potential for involving deeper contiguous structures and intracranial extension. The development of this congenital midline sinus of dorsum of nose has opened a new horizon in current concepts of embryology. Objective To study the embryological origin, presentation, treatment, and genetic associations of three cases of these sinus cysts. Clinical presentation This paper presents our experiences with managing three patients who presented with opening on nasal dorsum with recurrent swelling and purulent discharge from it. Imaging studies in these patients indicated a midline anterior nasal sinus tract with cranial dilatation but no intracranial connection. They were successfully managed surgically. Conclusion Nasofrontal dermoid sinus cysts have a unique embryological origin. A midline basal frontal dermoid associated with a dimple or sinus opening on the nasal dorsum with or without protruding hair and sebaceous discharge is the classical presentation. The purpose of this report is to emphasize that, though rare nasofrontal dermoid sinus cysts do occur in our practice and their clinical importance from rhinology point of view is their potential for intracranial communication. How to cite this article Maru Y, Gupta Y. Our Experiences with Congenital Midline Nasal Dermoid Sinus Cyst. Clin Rhinol An Int J 2014;7(1):43-46.

Congenital Isolated Midline Sinus of the Upper Lip: Clinical and Embryological Approaches

Objectives Congenital sinuses or fistulas of the lip are uncommon malformations, yet true medial upper-lip fistulas (MULFs) are extremely rare. We present a new case of congenital upper-lip fistula located in the midline of the philtrum of an 8-month-old girl. Intervention Complete surgical removal was performed with a combined extra- and intraoral approach. Histological examination revealed that the fistula was lined by squamous epithelium with sebaceous and mucous glands and hair follicles. Results Several embryological hypotheses have been proposed concerning these anomalies. This article reexamines and discusses major embryological theories on pathogenesis of sinuses or fistulas of the upper lip. We propose that early ectodermal inclusion events may occur in the medial fusion area during formation of the intermaxillary process. This embryological approach is highly concordant with our recent hypothesis on nasal dermoid sinus cysts (NDSCs) pathogenesis, in which we proposed an embryological hypothesis with early ectodermal inclusion phenomenon in the midline suture area to explain NDSCs pathogenesis. Conclusions Common early ectodermal inclusion phenomena could be involved in both NDSCs and MULFs pathogenesis.