학술논문
Preoperative Imaging and Surgical Findings in Pediatric Frontonasal Dermoids.
Document Type
Academic Journal
Author
Amin SN; Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A.; Siu JM; Division of Pediatric Otolaryngology-Head and Neck Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A.; Purcell PL; Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A.; Manning JP; Utah Facial Plastics and Aesthetics, Salt Lake City, Utah, U.S.A.; Wright J; Department of Radiology, Seattle Children's Hospital, Seattle, Washington, U.S.A.; Dahl JP; Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A.; Division of Pediatric Otolaryngology-Head and Neck Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A.; Hauptman JS; Division of Pediatric Neurosurgery, Seattle Children's Hospital, Seattle, Washington, U.S.A.; Hopper RA; Division of Craniofacial Plastic Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A.; Lee A; Division of Pediatric Neurosurgery, Seattle Children's Hospital, Seattle, Washington, U.S.A.; Manning SC; Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A.; Division of Pediatric Otolaryngology-Head and Neck Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A.; Perkins JN; Division of Pediatric Otolaryngology-Head and Neck Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A.; Susarla SM; Division of Craniofacial Plastic Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A.; Bly RA; Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A.; Division of Pediatric Otolaryngology-Head and Neck Surgery, Seattle Children's Hospital, Seattle, Washington, U.S.A.
Source
Publisher: Wiley-Blackwell Country of Publication: United States NLM ID: 8607378 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-4995 (Electronic) Linking ISSN: 0023852X NLM ISO Abbreviation: Laryngoscope Subsets: MEDLINE
Subject
Language
English
Abstract
Objective: To review cases of congenital frontonasal dermoids to gain insight into the accuracy of preoperative computed tomography (CT) and magnetic resonance imaging (MRI) in predicting intracranial extension.
Methods: This retrospective study included all patients who underwent primary excision of frontonasal dermoids at an academic children's hospital over a 23-year period. Preoperative presentation, imaging, and operative findings were reviewed. Receiver operating characteristic (ROC) statistics were generated to determine CT and MRI accuracy in detecting intracranial extension.
Results: Search queries yielded 129 patients who underwent surgical removal of frontonasal dermoids over the study period with an average age of presentation of 12 months. Preoperative imaging was performed on 122 patients, with 19 patients receiving both CT and MRI. CT and MRI were concordant in the prediction of intracranial extension in 18 out of 19 patients. Intraoperatively, intracranial extension requiring craniotomy was seen in 11 patients (8.5%). CT was 87.5% sensitive and 97.4% specific for predicting intracranial extension with an ROC of 0.925 (95% CI [0.801, 1]), whereas MRI was 60.0% sensitive and 97.8% specific with an ROC of 0.789 (95% CI [0.627, 0.950]).
Conclusion: This is the largest case series in the literature describing a single institution's experience with frontonasal dermoids. Intracranial extension is rare and few patients required craniotomy in our series. CT and MRI have comparable accuracy at detecting intracranial extension. Single-modality imaging is recommended preoperatively in the absence of other clinical indications.
Level of Evidence: 4 Laryngoscope, 134:1961-1966, 2024.
(© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)
Methods: This retrospective study included all patients who underwent primary excision of frontonasal dermoids at an academic children's hospital over a 23-year period. Preoperative presentation, imaging, and operative findings were reviewed. Receiver operating characteristic (ROC) statistics were generated to determine CT and MRI accuracy in detecting intracranial extension.
Results: Search queries yielded 129 patients who underwent surgical removal of frontonasal dermoids over the study period with an average age of presentation of 12 months. Preoperative imaging was performed on 122 patients, with 19 patients receiving both CT and MRI. CT and MRI were concordant in the prediction of intracranial extension in 18 out of 19 patients. Intraoperatively, intracranial extension requiring craniotomy was seen in 11 patients (8.5%). CT was 87.5% sensitive and 97.4% specific for predicting intracranial extension with an ROC of 0.925 (95% CI [0.801, 1]), whereas MRI was 60.0% sensitive and 97.8% specific with an ROC of 0.789 (95% CI [0.627, 0.950]).
Conclusion: This is the largest case series in the literature describing a single institution's experience with frontonasal dermoids. Intracranial extension is rare and few patients required craniotomy in our series. CT and MRI have comparable accuracy at detecting intracranial extension. Single-modality imaging is recommended preoperatively in the absence of other clinical indications.
Level of Evidence: 4 Laryngoscope, 134:1961-1966, 2024.
(© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)