Midline Nasal Tip Sinus

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Introduction Congenital midline sinus over tip of nose is a rare clinical presentation. Accurate diagnosis should be done to rule out intracranial extension and to prevent recurrence. Appropriate surgical approach depends upon location, extent and degree of intracranial extension. Management entails complete surgical excision of sinus tract. We discuss a rare case, where external rhinoplasty approach was used for excising recurrent sinus and patient was disease free. Case Report A 29 year old male patient with midline nasal tip sinus presented in our institute with history of opening over tip of nose since childhood associated with recurrent episodes of discharge from opening. Our objective is to present clinic-radiological-pathological profile of congenital nasal sinus along with review of literature. Discussion Nasal dermoid is rare embryological anomaly of ectodermal and mesodermal origin. Radiological imaging should be considered to rule out any intracranial extension. Goal of management is complete surgical excision with meticulous pre-operative and surgical planning to avoid complications and recurrence. External rhinoplasty provides best surgical exposure and allows excision of sinus tract.