case_images: PMC11827921_01
case_images: Intraoperative photo before incision demonstrating midline pit (arrow) indicative of nasal dermoid.
case_images: cureus-0017-00000077490-i01.jpg
case_images: PMC11827921_01_cureus-0017-00000077490-i01.jpg
case_images: FIG1
case_images: Examination of the nose was notable for an external midline pit with surrounding erythema, but no active drainage (Figure 1) or any obvious obstructive intranasal lesions on the anterior rhinoscopy.
case_images: Coronal T2 weighted image demonstrating the cyst in the nasal cavity/septum as well as the separate intracranial lesion.
case_images: cureus-0017-00000077490-i02.jpg
case_images: PMC11827921_01_cureus-0017-00000077490-i02.jpg
case_images: FIG2
case_images: There was also a separate intracranial dermoid noted, which was not connected to the nasal component (Figures 2-3).
case_images: T1 sagittal post contrast MRI demonstrating blind ending of lesion. . MRI, magnetic resonance imaging
case_images: cureus-0017-00000077490-i03.jpg
case_images: PMC11827921_01_cureus-0017-00000077490-i03.jpg
case_images: FIG3
case_images: There was also a separate intracranial dermoid noted, which was not connected to the nasal component (Figures 2-3).
case_images: Isolating and dissecting the cystic tract (blue arrow) away from the nasal septum (red arrow).
case_images: cureus-0017-00000077490-i04.jpg
case_images: PMC11827921_01_cureus-0017-00000077490-i04.jpg
case_images: FIG4
case_images: The lower lateral cartilages were divided with a #15 blade to expose the septal cartilage, which was further divided with a midline vertical incision to trace the sinus tract to a blind pouch in the middle of the septum (Figure 4).
case_images: Dissection of the cyst and tract via the open rhinoplasty approach. The tract (blue arrow) is being retracted still attached to the dorsal dermal portion.
case_images: cureus-0017-00000077490-i05.jpg
case_images: PMC11827921_01_cureus-0017-00000077490-i05.jpg
case_images: FIG5
case_images: The cyst and tract were removed in their entirety, along with the diseased epidermis from the dorsum of the nose (Figure 5).
case_images: Timeline of events in patient presentation.
case_images: cureus-0017-00000077490-i06.jpg
case_images: PMC11827921_01_cureus-0017-00000077490-i06.jpg
case_images: FIG6
case_images: Figure 6 shows a timeline of the patient's initial presentation to four months post-op.