Bardají Bofill Manel

What is it?

It is a subcutaneous cystic formation covered with normal skin, adhered to deep planes, sometimes to the bone, where it forms an excavation with decreasing thickness; Its consistency is hard or renitentient. Cysts located on the face and neck are relatively frequent; They represent 10% of all dermoid cysts in the body. They settle mainly in the embryonic clefts and sutures, predominating the locations in the periorbital regions, middle frontal line, eyebrow tail, nose and cervical midline.

Anatomopathologically, its inner wall is covered with epidermis with rudimentary or fully developed annexes. Its content is mucoid and sometimes houses hairs and, more rarely, other tissues. They develop from embryonic remains, their treatment being invariably surgical.

Cysts located on the tail of the eyebrow are very common in children, are always present at birth and grow slowly. They are not attached to the skin, but to the deep tissues and sometimes to the periosteum, lodging within a small cavity in the frontal bone above the orbital ridge. It is necessary to establish the differential diagnosis with lipomas and angiomas in this region. Its removal is done by incisions on the eyebrow.

The cysts of the nose are located almost exclusively in its midline, extending in depth towards the own bones, lamina cribosa and encephalon, upwards to the frontal bone and downwards to the bony palate; For this reason, the radiographic study is essential to determine the bone distortion caused by the cyst, as well as to establish the differential diagnosis with the encephalocele. Clinically they manifest in the middle or distal part of the dorsum of the nose through a small punctate hole through which hairs appear and periodically a purulent exudate. Other times, the least, they cross the lateral faces of the bones themselves or the suture line where these bones meet. For its excision is performed, a longitudinal incision is made in the back of the nose, so that it covers the hole and the fistulous path, and the central osteotomy through the suture of the bones themselves to separate it and have access route to the cyst. When the cyst cannot be removed in its entirety, it marsupializes to the nostril.

Cervical midline dermoid cysts are preferably located in the submental region, making prominence towards the skin or towards the sublingual region. They are rounded, painless, asymptomatic tumors due to their slow growth, not adhered to the skin, but sometimes they are to the genian process of the jaw. It is necessary to establish the differential diagnosis with the thyreoglossal cyst, with the groulas and the cyst of dental origin. Dermoid cysts are usually more superficial, centrally located higher than those of the thyreoglossus duct and are not attached to the hyoid bone, and a large number of them make prominence on the floor of the mouth. With the slot, whose wall is thinner, almost transparent, with a bluish content and its location is just in the middle line. With regard to fistulas of dental origin, they are not usually central and are related to a dental infectious focus. Its removal is done by incision in the submental region.