A Rare Cause of Unilateral Nasal Cavity Mass

Abstract

Nasal cavity masses in children pose a diagnostic challenge due to varied etiology and potential intracranial extension. Among these, frontoethmoidal meningoceles are rare congenital lesions, typically present in infancy with external nasal swelling or craniofacial abnormalities. Post-traumatic meningoceles are even rarer and may present as an intranasal mass, delaying diagnosis. Case: A case of a three-year-old girl with a progressively enlarging right nasal mass first noted at seven months of age following trauma is presented here. The lesion eventually protruded externally and caused periorbital swelling, noisy breathing, and mouth breathing, without cerebrospinal fluid (CSF) rhinorrhea or neurological deficits. Examination revealed a soft, pale-yellow mass with hypertelorism. Magnetic Resonance Imaging (MRI) revealed a cystic lesion in the right ethmoid region with a defect in the cribriform plate, consistent with a frontoethmoidal meningocele. The patient underwent right frontal craniotomy with trans nasal repair of the skull base defect with optimum postoperative recovery. Conclusion: Frontoethmoidal meningocele can present as a nasal mass in children, particularly after trauma, even without CSF leak or neurological deficits. Radiological evaluation is essential for diagnosis, and early surgical repair provides definitive management with a favorable outcome.