External rhinoplasty excision of a nasal tip glioma in a 6-month-old infant: Case report and review of the literature

SummaryIn this report, we describe an infant with a nasal tip glioma treated by excision via external rhinoplasty. A 3-month-old full-term, otherwise healthy infant presented with a slowly enlarging midline mass of the nasal tip. Clinically the mass appeared cystic without trans-illumination, enlargement with crying, or signs of infection. On successive CT scans at 3 and 5 months old the mass appeared as an enlarging focal prominence to the left of midline with central hypodensity without evidence for intracranial extension. Preoperatively the differential diagnosis included nasal dermoid, glioma, and hemangioma. The mass was removed at 6 months of age via an open rhinoplasty approach with conchal cartilage grafting to reconstruct the left upper lateral cartilage. The final pathological diagnosis was nasal glioma (glial heterotopia) with fibrosis. Pre-operative, intra-operative, and post-operative photos were taken. The patient has been followed up for 6 months without evidence of recurrence or other complications. A review of the literature on nasal glioma and external nasal surgery in infancy is presented.