International Journal of Clinical & Medical Images

27 years old female presented with infected cyst like swelling over dorsum of nose, which was diagnosed clinically as infected midline nasal dermoid and underwent Incision and Drainage along with systemic antibiotic therapy. After control of infection she was evaluated radiologically and prepared for surgery. Careful preoperative examination was done to plan the excision which showed the sinus tract and soft tissue mass over dorsum of nose, without having any intracranial extension. Probing of the sinus tract and injection of dye like methylene blue helped to trace the tract during excision. Z-plasty incision over dorsum of the nose which provides adequate exposure and good post-operative cosmesis was planned. After giving incision soft tissue dissection was carried out gently to separate the cyst or tract from surrounding tissue. Next an incision was given over periosteum of nasal bones. A midline nasal osteotomy was performed for better exposure. After complete excision of the cyst or tract, nasal periosteum was sutured in midline followed by soft tissue by 4-0 synthetic absorbable (vicryl) suture and the skin was sutured by 4-0 monofilament (ethilon) suture without tension