History of Management of Dermal Sinus Tracts in Children

Understanding of Disease

• 1875- first description: Eppinger was the first to describe a spinal “cholesteatoma” or dermoid (24).
• 1913 – first surgery: Verebely first described a dermal sinus and its surgical removal in 1913(25).
• 1934 – termed congenital: Walker and Bucy first used the term “congenital dermal sinus” in 1934 (26).

Technological Development

• Imaging: The introduction of MRI has led to earlier diagnosis and a lessening of the potential complications of infection and neurological deficits (2).

Surgical Technique

• Surgical microscope: The introduction of the surgical microscope has improved visualization due to its magnification and improved lighting of the surgical field.
• IOM: Electrophysiological monitoring during surgery and, in particular, the availability of mapping of neural structures using electrical stimulation has allowed for the identification of functional neural structures associated with the sinus tract and a greater likelihood of their preservation.