Nasolabial cyst in a patient with cleft lip and palate

Nasolabial cyst: case report and review of management options

Background

Nasolabial cysts are rare, non-odontogenic, soft-tissue cysts that develop between the upper lip and nasal vestibule with an overall incidence of 0.7% out of all maxillofacial cysts. The predominant presentation of a nasolabial cyst is a painless localized swelling with varying degrees of nasal obstruction. Several treatment modalities have described in the management of the nasolabial cyst. In this paper, we present a case of a nasolabial cyst in a 44 years old man with discussions of the treatment modalities in the lights of the literature.

Case presentation

We present a case of a nasolabial cyst in a 44-year-old man that slowly increased in size through a period of 3 years, with associated mild pain and nasal obstruction. It had caused a mass effect upon the maxilla, resulting in scalloping. The cyst was excised entirely with no evidence of recurrence at the two months follow up.

Conclusions

The nasolabial cyst is a rare soft-tissue cyst. Complete surgical excision using an open approach performed to our case, which considered with the complete endoscopic removal of the best treatment for the nasolabial cysts with a rare recurrence rate.

Bilateral nasolabial cyst: a rare case

Nasolabial cysts are rare non-odontogenic cysts characterised by their extraosseous appearance and are always located near to ala nasi. They are painless and located beneath the mucosa leading to soft tissue swelling and elevation of nasal ala. Bilateral nasolabial cyst is a rare occurrence. This case report describes the clinical diagnostic features and multimodal imaging appearance of nasolabial cyst with review of literature.

Bilateral nasolabial cysts: a case report

Background

Nasoalveolar cysts are rare non-odontogenic cysts that occur beneath the nasal alar region. Few cases of bilateral nasoalveolar cysts have been described.

Case presentation

We report a rare case of a 67-year-old Japanese woman with bilateral nasoalveolar cysts who presented to our department with the chief complaint of a swollen left nasal alar base. Panoramic radiography revealed no abnormalities. Computed tomography and magnetic resonance imaging revealed a well-circumscribed oval lesion at both alar bases. Therefore, bilateral nasoalveolar cysts were clinically diagnosed. Furthermore, these cysts were extirpated under general anesthesia; the aforementioned diagnosis was histopathologically confirmed. No recurrence has been observed 1 year after surgery.

Conclusions

Nasoalveolar cysts are rare. It is necessary to be careful because nasoalveolar cysts can show bilateral occurrence.

Factors associated with postrhinoplasty mucous cyst in cleft lip patients

PURPOSE

The purpose of this study was to identify risk factors associated with postrhinoplasty mucous cyst (PMC) among adult cleft patients undergoing rhinoplasty. PMC has been reported sporadically in the literature. Its aetiology is uncertain. The purpose of this study was to determine whether three factors, (1) patient age, (2) surgical trauma, and/or (3) use of a nasal septal cartilage graft (NSCG), were risk factors for PMC.

METHODS

We organized a retrospective, single-center study and enrolled cleft rhinoplasty patients treated between January 2003 and December 2008. The predictor variables included age at surgery, use of a NSCG, and length of surgery. The primary outcome was presence of PMC. Other study variables included demographic, surgical, and postoperative data. Appropriate descriptive and univariate statistics were calculated, and P < 0.05 was regarded as indicative of statistical significance.

RESULTS

The sample comprised 314 cleft rhinoplasty patients (118 females; 37.6 %) with a mean age of 14.9 ± 10.7 years (range 0-65). Three patients had a PMC after secondary cleft rhinoplasty. Average time to disease was 26 ± 19.3 months after surgery (range 12-48). There was no significant association between the presence of the PMC and the three predictor variables-patient's age, NSCG transplantation, and protracted surgery (P > 0.05).

CONCLUSIONS

These study findings suggest that young age, use of a NSCG, and protracted surgery are not risk factors for PMC. The prevalence of PMC is greater for cleft patients after rhinosurgery than for noncleft patients.

Nasolabial cysts: A systematic review of 311 cases

OBJECTIVES/HYPOTHESIS

Nasolabial cysts are rare nonodontogenic cysts arising commonly in the nasal alar region. Intraoral sublabial resection of nasolabial cysts is considered the standard treatment modality. In the past 16 years, transnasal endoscopic marsupialization has emerged as an alternative approach for these lesions. A systematic review on this entity was performed to evaluate management and outcomes.

DATA SOURCES

PubMed/MEDLINE Database.

METHODS

A search of literature including nasolabial cysts, nasoalveolar cysts, and Klestadt's cysts was performed using the PubMed/MEDLINE database. Parameters regarding presentation, treatment, imaging, histology, and complications were extracted and subsequently analyzed.

RESULTS

Seventy-nine articles with 311 patient cases were included in this analysis. In cases reporting location, nasolabial cysts occurred 46.9%, 37.5%, and 10.9% on the left, right, and bilaterally, respectively. The most common presenting complaint was facial swelling in 168 out of 237 patients (70.9%). Computed tomography was the most commonly employed imaging study (n = 170). Surgical excision of nasolabial cysts was performed using an intraoral sublabial approach in 184 patients. Seventy-nine patients underwent endoscopic transnasal marsupialization. The most common complication following surgical treatment of nasolabial cysts was postoperative facial/perinasal swelling. Three and two recurrences were reported in the sublabial excision group and transnasal marsupialization group, respectively. Mean follow-up time was 20.0 months.

CONCLUSIONS

Endoscopic transnasal marsupialization is a relatively new alternative to intraoral sublabial resection of nasolabial cysts, with similar efficacy. The rates of postoperative swelling, pain, and recurrence are similar in both groups.

Unusual postrhinoplasty complication: nasal dorsum cyst

Among all the possible complications of aesthetic rhinoplasty, a rare one is the development of cystic masses on the nasal dorsum: several theories suggest that cysts develop commonly by entrapment of nasal mucosa in the subcutaneous space, but they can also originate from foreign body reactions. This report deals with two cases of nasal dorsum cysts with different pathogenesis: both patients had undergone aesthetic rhinoplasty in the past (26 years ago and 14 years ago, resp.). Both cystic masses were removed via a direct open approach and nasal reconstruction was performed successfully with autologous vomer bone. The pathologic investigations showed a foreign body inclusion cyst associated with latex rubber in the first case and a sequestration of a mucosal-lined nasal bone was not removed at the time of primary rhinoplasty in the second case. A brief review of the literature focuses on the pathophysiology and treatment options for nasal dorsal cysts following aesthetic rhinoplasty.

Diagnosis of the nasolabial cyst: case report

INTRODUCTION: The nasolabial cyst is classified in the group of non-odontogenic epithelial developmental cysts. Their occurrence is rare, however, they are located in the nasolabial sulcus, close to the alar insertion in the nose, external to the maxillary bone tissue. It is characterized as a floating tumor, generally asymptomatic, which promotes elevation on the nasal ala. OBJECTIVE: To report a case of nasolabial cyst addressing clinical, histopathological and radiological aspects, in order to alert professionals as regards their responsibility in diagnosis. MATERIAL AND METHOD: Female patient with a swelling in the region of the upper lip and nasal ala. After clinical examination, radiographic examination, puncture and aspiration, total surgical enucleation of the cyst was performed and the material collected was sent for histopathologic analysis. CONCLUSION: the dentist must be alert in order to make an early diagnosis, because it is not uncommon to overlook the lesion in the early stages.

Diagnosis and surgical treatment of a nasolabial cyst

Nasolabial cysts are uncommonly diagnosed nonodontogenic soft tissue lesions located close to the nasal alar region of the face, presenting as extraosseous swelling in the region of the nasolabial fold. Nasolabial cysts are likely to remain undetected unless and until they become infected or are associated with facial deformity. Histologically, it is lined with nonkeratinized squamous epithelium or, more frequently, with respiratory-type cylindrical epithelium with goblet cells. The aim of this article was to present and discuss the surgical management of a case of nasolabial cyst and to briefly review the literature.

[Fifty-four cases of nasolabial cysts]

INTRODUCTION

Nasolabial cysts (NLC) are a rare condition presenting as cystic epithelial lesion. We report the clinical and radiological (CT scan) aspects of this rare clinical entity and we assess the various available surgical treatment.

PATIENTS AND METHODS

Fifty-four patients presenting with NLC underwent surgery between 2000 and 2009. The diagnosis was made on clinical and radiological arguments and confirmed by histological examination after surgical excision. The studied parameters were: gender, functional signs having led to consultation, localization, results of radiological exploration, treatment modalities, anatomopathology and postoperative evolution.

RESULTS

The average age of the 30 men and 24 women was 38 years with extremes ranging between 24 and 53 years. The reason for consultation was swelling of the anterior nasal floor in every case and a nasal obstruction for 33 patients. The average time between initial swelling and consultation was 18 months. Swelling was unilateral for 52 patients. CT scan was prescribed for 20 patients and revealed a cystic mass with an average diameter of 23 mm. Cyst excision was made under general anesthesia in every case. Most of the patients (52) were operated via a vestibular approach. Histological examination confirmed the diagnosis of nasolabial cyst in every case.

DISCUSSION

NLC is a rare condition which must be suggested when a cystic mass is found in the anterior nasal floor. CT scan confirms the diagnosis and cyst extension. Cyst excision is performed by vestibular approach. The endoscopic marsupialization is an interesting new therapeutic alternative.

Inclusion mucous cysts of the nose: a late complication after septorhinoplasty in two cleft lip patients

BACKGROUND

Mucous cysts of the nose are a rare complication of rhinoplasty. They may develop as a result of implantation or herniation of mucosa. The entrapped epithelium may proliferate, forming a subcutaneous cyst.

PATIENTS AND METHODS

Two patients with unilateral cleft lip nose deformity had previously undergone corrective rhinoplasty. Years after the operation, they noticed a growing mass in the nasal dorsum and presented for revision rhinoplasty. Complete surgical removal was performed by an open approach, and plastic reconstruction was performed with a rib cartilaginous graft.

RESULTS

In both cases, histopathological investigation revealed a mucous cyst. No recurrence of disease was observed over 2 years of monitoring.

CONCLUSION

Nasal mucous cysts are not specific complications of corrective surgery for cleft lip nose. Displacement of fragments of epithelium should be avoided to prevent this unwanted sequela. For complete removal, open rhinoplasty is recommended.

Transnasal endoscopic marsupialization of bilateral nasoalveolar cysts

Nasoalveolar cysts are uncommon nonodontogenic and developmental cysts with an uncertain pathogenesis. This cyst has been reported to occur bilaterally in 10-11% of cases. This case report describes a 45-year-old woman in whom the clinicopathologic findings were consistent with bilateral nasoalveolar cysts. The authors report a new, less invasive method for transnasal endoscopic marsupialization of bilateral nasoalveolar cysts. Transnasal endoscopic marsupialization has benefits for the treatment of bilateral and unilateral nasoalveolar cysts.