ABSTRACT
As an otorhinolaryngologist it is not an everyday occurrence to find a swelling in the nasolabialfold area. The challenge however lies in the diagnosis, proper and timed treatment of the existing pathology, especially in a non –infective case. There are various pathologies that can lead to a swelling in the nasolabial area. We here report a rare case of a female patient who presented to our outpatient department with a slowly progressive nasolabial swelling which radiologically pointed towards a Nasolabial cyst. However, the final diagnosis was an entity on the other end of spectrum, an Ameloblastoma, an odontogenic tumor
ABSTRACT
Los quistes nasolabiales son lesiones quísticas poco frecuentes, que se presentan como ocupación de la fosa canina, el ala nasal o el vestíbulo nasal. Usualmente son asintomáticas, pero pueden infectarse. El diagnóstico se realiza con el examen físico y exámenes imagenológicos, como la tomografía computarizada y/o resonancia magnética. El tratamiento consiste en la extirpación quirúrgica completa por abordaje sublabial, o por marsupialización endoscópica transnasal. Se describen dos casos, uno de ellos es una paciente de sexo femenino que presenta deformidad nasal producto del crecimiento progresivo de un quiste nasolabial unilateral, y otro de un paciente de sexo masculino que presenta una celulitis facial severa, con una tomografía computarizada que muestra quistes nasolabiales bilaterales. Los quistes nasolabiales deben ser considerados como parte del diagnóstico diferencial en otorrinolaringología en cuadros de deformidad nasal y aumento de volumen facial.
Nasolabial cysts are a rare developmental cyst, presenting as a fullness of canine fossa, nasal ala or vestibule of the nose. They are usually asymptomatic but may become infected. The diagnostic approach includes physical examination and imaging studies such as computed tomography and/or magnetic resonance imaging. Treatment is complete surgical excision by sublabial approach, or transnasal endoscopic marsupialization. Here we describe two cases, one female presenting as nasal deformity due to progressive growth of unilateral nasolabial cyst, and a healthy young male presenting severe facial cellulitis, with a computed tomography showing bilateral nasolabial cysts. Nasolabial cyst should be incorporated in the differential diagnosis of nose deformities and facial swelling in otorhinolaryngology.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Nose Diseases/surgery , Nose Diseases/diagnostic imaging , Cysts/surgery , Cysts/diagnostic imaging , Tomography, X-Ray Computed , Endoscopy/methods , Nasolabial FoldABSTRACT
O cisto nasolabial é classificado como um cisto não odontogênico de desenvolvimento da região oral e maxilofacial. Ele representa uma lesão extra-óssea rara, correspondendo a apenas 0,7% de todos os cistos que ocorrem na região maxilofacial. Clinicamente, ocorre como uma tumefação no lábio superior e na região do sulco nasolabial, causando um aumento de volume na região alar nasal. Os autores relatam dois casos de cisto nasolabial, enfatizando os aspectos clínicos, tomográficos, histológicos e técnicas de excisão cirúrgica... (AU)
The nasolabial cyst is classified as a non-odontogenic and development cyst of the oral and maxillofacial region. It represents a rare extra-osseous lesion, corresponding to only 0.7% of all cysts that occur on the maxillofacial region. Clinically, it occurs as a tumefaction in the upper lip, at the nasolabial furrow region, causing a swelling on the nasal alar region. The authors report two cases of nasolabial cyst, emphasizing their clinical, tomographic and histological aspects and techniques of surgical excision... (AU)
Subject(s)
Humans , Female , Adult , Surgery, Oral , Jaw Cysts , Nonodontogenic Cysts , Nasolabial FoldABSTRACT
Nasolabial cyst is a rare non-odontogenic, developmental cyst that occurs in sublabial and premaxillary area. This cyst is usually unilateral, but it occurs bilaterally about 10% of cases. A 55-year-old woman visited our clinic with asymptomatic bilateral nasolabial swelling. Evaluation of history, physical examination and CT scan led to the diagnosis of a nasolabial cyst, and surgical excision was performed via sublabial approach. In intraoperative finding, two nasolabial cysts of similar size that entirely divided by anterior nasal spine were identified. The pathologic findings were consistent with nasolabial cysts. We herein report a rare case of bilateral occurrence of nasolabial cysts with a review of literatures.
Subject(s)
Female , Humans , Middle Aged , Physical Examination , SpineABSTRACT
Nodular fasciitis is a benign proliferative spindle-cell lesion that presents as a rapidly growing mass with rich cellularity and mitotic activity, leading to its frequent misidentification of a sarcoma. Most cases of nodular fasciitis are diagnosed in adults aged 20-40 years and is rarely seen during the first 4-5 years of life. Because of its rapid growth and bony erosion, it often mimics malignancy. We report a case of an 18-month-old infant with a rapidly growing mass on the right nasolabial fold. Because of the anatomic location and CT findings, we first suspected nasolabial cyst. However, it proved to be an intramuscular type of nodular fasciitis, a very rare occurrence in infancy.
Subject(s)
Adult , Aged , Humans , Infant , Fasciitis , Nasolabial Fold , SarcomaABSTRACT
O cisto nasolabial é um cisto raro de tecidos moles, de origem não-odontogênica que resulta de uma alteração do desenvolvimento ectodérmico, apresentando-se clinicamente por um aumento de volume na região de lábio superior, base e asa do nariz. Geralmente, é assintomático, exceto nos casos de infecção, podendo provocar comprometimento estético dada a sua evolução progressiva. O tratamento de escolha é a excisão cirúrgica, tendo bom prognóstico e raras recidivas. O objetivo deste trabalho foi apresentar um caso de cisto nasolabial unilateral, bem como, uma revisão da literatura sobre a doença.
The nasolabial cyst is an uncommon,nonodontogenic, soft tissue cyst characterized by its extra bone located in the nasal region. This cyst is generally asymptomatic, except in cases of infection,and can cause complaints arising from aesthetic appearance. The treatment of choice is surgical excision, which presents a good prognosis and rare recurrence. This case report presents a unilateral nasolabial cyst as well as a literature review on the disease.
Subject(s)
Humans , Female , Adult , Nonodontogenic Cysts , Cysts/diagnosisABSTRACT
OBJECTIVES: Surgical excision via a sublabial approach is considered the standard treatment for nasolabial cysts. Although transnasal marsupialization has been proposed as an alternative method, no prospective study has compared the effectiveness of these techniques. We thus compared the surgical procedure, operating time, postoperative pain, complications, and recurrence rate between the two surgical methods. METHODS: Twenty patients diagnosed with nasolabial cysts were allocated randomly into two groups according to the surgical technique. In the sublabial approach group, the cysts were excised completely using a sublabial approach, while in the transnasal marsupialization group, the cysts were marsupialized transnasally under the guidance of nasal endoscopes. The pure operating time was measured and postoperative pain was evaluated using a visual analog scale. Complications after the procedure were assessed and recurrence was determined according to the clinical symptoms and postoperative radiologic findings. RESULTS: The transnasal marsupialization group had significantly shorter operating times, less postoperative pain, lower complication rates, and shorter duration of side effects than the sublabial approach group. No recurrence occurred in either group after a 1-yr follow-up period. CONCLUSION: Although both methods are effective for treating nasolabial cysts, the transnasal marsupialization of nasolabial cysts has many benefits over the conventional sublabial approach. Therefore, we propose that transnasal marsupialization be the treatment of choice for nasolabial cysts.
Subject(s)
Humans , Endoscopes , Follow-Up Studies , Pain, Postoperative , Prospective Studies , RecurrenceABSTRACT
O cisto nasolabial é um cisto não odontogênico raro que se desenvolve na região inferior da asa nasal, com patogênese ainda incerta. Esta lesão, que possui crescimento lento e dimensões variáveis (1,5-3cm), caracteriza-se clinicamente por uma tumefação flutuante na região do sulco nasolabial ao redor da asa do nariz, causando uma elevação do lábio superior. Seu diagnóstico pode ser feito basicamente pelo quadro clínico e, se necessário, complementando-se com exames auxiliares por imagens. O presente trabalho relata o caso de uma paciente do sexo feminino de 48 anos, que se queixava da presença de uma massa consistente na região da asa esquerda do nariz e cujas características clínicas eram compatíveis com cisto nasolabial. As imagens de TC demonstraram uma formação expansiva com densidade de tecido mole, localizadas na região nasal esquerda medindo cerca de 1,2cm de diâmetro e apresentando contornos nítidos e bem definidos e densidade homogenia ao redor de 50 UH. Já as imagens de RM mostraram uma lesão de aspecto circular localizada em tecido mole, apresentando hiperintensidade nas imagens ponderadas em T1, T2 e no recurso de supressão da gordura, sendo a hipótese diagnóstico de cisto nasolabial, confirmado pelo exame histopatológico depois da cirurgia.
The nasolabial cyst is an uncommon non-odontogenic cyst that develops in the lower region of the nasal ala; its pathogenesis is uncertain. This lesion grows slowly and measures between 1.5 and 3 cm; it is characterized clinically by a floating tumefaction in the nasolabial sulcus, which elevates the upper lip. The diagnosis is based on the clinical findings and, if necessary, image exams. This paper reports a case of a white 48-year-old Brazilian female patient that presented a firm tumor in the left ala of the nose; the clinical features suggested a nasolabial cyst. CT scans revealed an expanding tumor with soft tissue density located in the left ala of the nose. It measured 1.2 cm in diameter and had a clear and well-defined outline; its homogeneous density was about 50 HU. MR images revealed a circular lesion located in soft tissue; T1 and T2 weighted signals were hyperintense, as were images after fat suppression. The diagnosis was a nasolabial cyst, which was confirmed by histopathology after surgery.
Subject(s)
Female , Humans , Middle Aged , Cysts/diagnosis , Lip Diseases/diagnosis , Nose Diseases/diagnosis , Cysts/surgery , Lip Diseases/surgery , Magnetic Resonance Imaging , Nose Diseases/surgery , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Dermoid cysts can be found anywhere in the body, particularly in areas where embryonic elements fuse together. Dermoid cysts arising in the head and neck lesion are relatively common, but that of nasolabial area has not been reported. Recently, we experienced a case of epidermoid cyst mimicking nasolabial cyst. The patient was a 49 year-old man with an anterior nasolabial swelling that has been presented for 1 year. After cyst excision, a histologic examination revealed that it was an epidermoid cyst. We report this case with the literature review.
Subject(s)
Humans , Dermoid Cyst , Epidermal Cyst , Head , NeckABSTRACT
O cisto nasolabial caracteriza-se como lesão não-odontogênica de partes moles, rara e com ocorrência em situação paramediana, anteriormente ao rebordo alveolar da maxila e à asa do nariz. Portratar-se de lesão de tecido mole, geralmente não produz alteração radiográfica. No presente trabalho são descritos dois casos de cisto nasolabial, nos quais são evidenciados aspectos relevantes em relação ao diagnóstico diferencial por meio de tomografia computadorizada e ressonância magnética, bem como os aspectos atípicos encontrados em um dos casos relatados, como bilateralidade e diferença de intensidade de sinal à ressonância magnética. São discutidos, ainda, fatores determinantes para o diagnóstico diferencial de lesões de tecido mole do complexo maxilofacial,como cistos fissurais de ocorrência central (sagital), entre eles dermóides, palatinos e nasopalatinos (cisto do canal do incisivo), e cistos de fissura lateral.
The nasolabial cyst is defined as nonodontogenic soft tissue lesion, rare and with occurrence in sagittal plane, between midline and nasal cartilage. Because its soft tissue composition, there is no radiographic presentation in conventional radiographic examination,being indicated evaluation through computed tomography and magnetic resonance imaging. In the present study, two cases are discussed, being one in white female subject, 72-year-old, and other in a black male subject, 24-year-old. The authors discuss about relevant aspects related to differential diagnosis through computed tomography and magnetic resonance imaging, as wellas atypical features founded in one of the cases, like bilateral occurrence with different signal intensity in magnetic resonance imaging and determinant factors for differential diagnosis of softtissues pathologies of maxillofacial complex, as fissure cysts with central occurrence (sagittal cysts), as dermoid cysts, palatine and nasopalatine and lateral fissure cysts.
Subject(s)
Humans , Male , Female , Young Adult , Aged , Cysts/diagnosis , Lip Diseases/diagnosis , Nose Diseases/diagnosis , Magnetic Resonance Spectroscopy , Tomography, X-Ray Computed , Diagnosis, DifferentialABSTRACT
BACKGROUND AND OBJECTIVES: Being probably of embryonal in origin, the nasolabial cyst is relatively rare and is thought to arise either from the epithelial remnants entrapped along the lines of fusion during the development of face or from the remnants of the developing nasolacrimal duct. The purpose of this study was to examine the clinical and radiological features of nasolabial cyst in order to provide basis for its correct diagnosis and treatment. MATERIAL AND METHODS: The nine cases of nasolabial cyst which were treated in Masan Samsung Hospital from January in 1991 to April in 1997 were the used as subjects. These cases were examined according to age and sex distribution and their clinical features, radiologic and histologic findings, treatment and prognosis, were studied. RESULTS: In our study of nine cases of nasolabial cyst, more females than males were observed, and with respect to age, individuals in their Fortise were more frequently noted. Also, swelling of nasolabial fold were the most frequently observed among symptom and signs. Computerized tomography shows well-circumscribed cystic mass lateral to pyriform aperture. Seven cases underwent operation. Six cases were excised by intraoral sublabial approach, one case which forms fistula to skin was removed by transcutaneous approach. CONCLUSION: Nasolabial cyst is benign harmatomatous cyst of face. This lesion is often unrecognized or confused with other intranasal mass, other fissural and odontogenic cysts, midface infection, or swelling in the nasolabial area. Therefore careful clinical and radiologic evaluation should be considered in the differential diagnosis.