Do I Need Surgery for a Nasolabial Cyst? Concerns About Keloid Risk

Nasal labial cyst

Recently, an MRI revealed the presence of a nasolabial cyst.
Is surgery absolutely necessary? Additionally, I have a keloid tendency.
If I undergo endoscopic surgery, is there a chance that keloids could develop at the sinus opening, potentially causing breathing difficulties? I am quite concerned and would like to consult a doctor about this.

Stephanie, 40~49 year old female. Ask Date: 2016/10/18

Dr. Ji Zhaoyun reply Otolaryngology

Hello Stephanie, based on your description, a "nasolabial cyst" is generally difficult to resolve without surgical removal.
If left untreated, it may frequently become inflamed and enlarged in the future.
Surgery can be performed from the inside of the lip (which is more common) or from the base of the nasal passage, depending on the surgeon's assessment.
Given the information you have provided, if it is a typical "nasolabial cyst," it should not involve the sinus opening.
However, if it is a "sinus cyst," it may be advisable for you to return for a consultation with an ear, nose, and throat specialist.
Wishing you peace and good health.
Sincerely, Dr.
Chi Chao-Yun, Director of the ENT Department, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2016/10/18

More Info

When considering whether to undergo surgery for a nasolabial cyst, there are several factors to weigh, especially given your concern about keloid formation due to your predisposition to keloids (also known as hypertrophic scars).
A nasolabial cyst is a benign, fluid-filled sac that typically occurs in the area between the nose and the upper lip. While these cysts are not cancerous and often do not cause significant symptoms, they can lead to discomfort or cosmetic concerns, prompting individuals to consider surgical removal. The decision to proceed with surgery should be based on several considerations:
1. Symptoms and Impact on Quality of Life: If the cyst is causing discomfort, pain, or affecting your appearance to the point where it impacts your self-esteem or daily activities, surgery may be warranted. If the cyst is asymptomatic and not causing any issues, a conservative approach may be more appropriate.

2. Risk of Infection or Complications: While nasolabial cysts are generally not prone to infection, any surgical procedure carries inherent risks, including bleeding, infection, and complications related to anesthesia. In your case, the concern about keloid formation is particularly relevant. Keloids can develop after surgical procedures, especially in individuals with a history of keloid formation.
3. Surgical Technique: The method of surgery can influence the risk of keloid formation. Endoscopic techniques, which involve smaller incisions, may reduce the risk of scarring compared to traditional open surgery. However, even with minimally invasive techniques, there is still a risk of keloid formation, particularly in areas where the skin is more prone to scarring.

4. Postoperative Care: If you decide to proceed with surgery, it is crucial to follow postoperative care instructions carefully. This may include keeping the surgical site clean, avoiding sun exposure, and possibly using silicone gel sheets or other treatments to minimize scarring. Discussing your keloid history with your surgeon can help them tailor the surgical approach and postoperative care to mitigate this risk.

5. Consultation with Specialists: Given your concerns, it may be beneficial to consult with both an otolaryngologist (ENT specialist) and a dermatologist or plastic surgeon experienced in keloid management. They can provide insights into the best surgical options and strategies to minimize the risk of keloid formation.

In conclusion, whether or not to undergo surgery for a nasolabial cyst is a decision that should be made collaboratively with your healthcare providers, taking into account your symptoms, the potential benefits and risks of surgery, and your history of keloid formation. If surgery is deemed necessary, ensure that you discuss all your concerns, including the risk of keloids, with your surgical team to develop a comprehensive plan that addresses your unique needs.

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