Radiological diagnostics in nasal dermoids: Pitfalls, predictive values and literature analysis

Int J Pediatr Otorhinolaryngol. 2021 Oct:149:110842. doi: 10.1016/j.ijporl.2021.110842. Epub 2021 Jul 17.

Abstract

Objective: The study aimed to present the accuracy of radiological diagnostics in pediatric patients with nasal dermoids and to discuss the potential factors influencing the radiological pitfalls on imaging in these cases.

Material and methods: The patient's cohort included 25 surgically treated pediatric cases with nasal dermoid. The results of preoperative imaging studies were analyzed regarding intraoperative findings. A review of the literature concerning a series of cases with nasal dermoid was performed in order to evaluate the possible radiological pitfalls and the accuracy of radiological imaging. The following statistical parameters for the particular radiological tools was determined: sensitivity, specificity, predictive positive values and predictive negative values.

Results: Total number of 18 CT and 14 MRI were performed. 6 out of 32 radiological examinations occurred to be inconsistent with operative findings. Potential pitfalls were identified and discussed. All the patients with false radiological results were below the age of 5 and 83% were below the age of 3 y.o. The overall sensitivity (S), specificity (SP), predictive positive value (PPV) and predictive negative value (PNV) for CT vs. MRI were 68% vs. 79%, 90% vs. 95%, 65% vs. 86% and 90% vs. 92%, respectively.

Conclusions: MRI technique characterizes with higher predictive values in terms of identifying intracranial extension of nasal dermoid on imaging. Further analysis of radiological methods' accuracy should be conducted based on the detailed data concerning age distribution. The combination of CT and MRI should become a gold standard in diagnostics of nasal dermoids in children under the age of 5.

Keywords: Anterior skull base; Children; Imaging; Intracranial extension; Nasal dermoid.

Publication types

  • Review

MeSH terms

  • Child
  • Dermoid Cyst* / diagnostic imaging
  • Dermoid Cyst* / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Nose Neoplasms* / diagnostic imaging
  • Nose Neoplasms* / surgery
  • Radiography
  • Tomography, X-Ray Computed