Nasal glioma

Nasal glioma, also known as nasal glial heterotopia, is a rare, congenital, non-malignant mass composed of ectopic glial tissue that is not connected to the central nervous system (CNS). These masses are present at birth and result from abnormal embryologic development.

Pathophysiology

Nasal gliomas arise due to:

• Abnormal separation of glial tissue during embryogenesis.
• The ectopic glial tissue becomes trapped in the nasal cavity or subcutaneous tissue.

The mass is composed of mature glial cells, fibrous connective tissue, and may contain cerebrospinal fluid in rare cases.

Types

Nasal gliomas are categorized into three types based on their location:

• Extranasal: Located outside the nasal cavity, often appearing as a mass on the nasal bridge.
• Intranasal: Found within the nasal cavity, causing nasal obstruction.
• Mixed: Involving both intra- and extranasal components.

Clinical Presentation

Common signs and symptoms of nasal glioma include:

• Visible nasal mass (extranasal glioma).
• Nasal obstruction or difficulty breathing (intranasal glioma).
• Snoring or noisy breathing in infants.
• Nasal discharge, often unilateral.
• Cosmetic deformity, especially in extranasal lesions.

Diagnosis

The diagnosis of nasal glioma requires a combination of clinical examination and imaging studies:

• Physical examination: Palpation reveals a firm, non-compressible, non-pulsatile mass.
• Imaging:

 * CT scan: Useful for assessing the bony structures and location of the mass.
 * MRI: Provides detailed soft tissue visualization and helps rule out CNS connections.

• Biopsy: Rarely performed due to the risk of complications but can confirm the diagnosis if necessary.

Differential Diagnosis

Conditions that may mimic nasal glioma include:

• Dermoid cyst
• Encephalocele
• Hemangioma
• Nasal polyps

Treatment

The primary treatment for nasal glioma is:

• Surgical excision: Complete removal of the mass is recommended to prevent complications such as infection, nasal obstruction, or cosmetic deformity.
• Preoperative imaging is essential to plan the surgery and confirm the absence of CNS connections.

Prognosis

With complete surgical excision, the prognosis for nasal glioma is excellent. Recurrence is rare if the mass is entirely removed.

See Also

• Congenital nasal masses
• Glial tissue
• Encephalocele

References

1. Park, A.H., et al. "Congenital Nasal Masses: Diagnosis and Management." Otolaryngologic Clinics of North America, 2012.
2. Dubois, J., and Garel, L. "Imaging of Congenital Nasal Malformations." Pediatric Radiology, 2007.