Case Report - A rare case report of supernumerary nostril in an infant - clinical presentation, surgical management and literature review

Sep 29, 2026

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A rare congenital malformation case describes a 7-month-old female infant with a left-sided accessory nostril-like tubular structure present since birth. Physical assessment revealed a superior, skin-covered tract with a small distal opening, without respiratory distress or infection history. Contrast-enhanced CT demonstrated a blind-ending soft-tissue tract without communication to the nasal cavity, paranasal sinuses, intracranial structures, or associated bony anomalies. Complete surgical excision with layered reconstruction of the nasal ala was performed; histopathology confirmed ciliated respiratory epithelium. Recovery was uneventful with satisfactory cosmetic symmetry at 12 months.

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Case Report

Introduction

Case presentation

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# Case Report A rare case report of supernumerary nostril in aninfant: clinical presentation, surgical management,and literature review Dipesh Kumar Singh, MBBS*, Nitesh Pandit, MBBS, Isha Dhakal, MBBS, Ajay Kumar Yadav, MD Introduction and Importance: Supernumerary nostril is an exceedingly rare congenital malformation characterized by thepresence of an accessory nostril in addition to the normal nasal openings. The anomaly may or may not communicate with thenasal cavity. Case Presentation: We report a case of a 7-month-old female infant presenting with a tubular structure superior to the left nasalala, consistent with a supernumerary nostril. Contrast-enhanced computed tomography (CT) of the face demonstrated a blind -ending soft-tissue tubular tract without communication to the nasal cavity or paranasal sinuses. There were no encephaloceles,bone deformities, or other midline anomalies identified. The tract was completely excised, andthe left nasal ala was reconstructedwith layered primary closure. Histopathology confirmed ciliated respiratory epithelium lining the tract. Postoperative recovery wasuneventful. At 12-month follow-up, the patient demonstrated satisfactory cosmetic symmetry and no evidence of recurrence.Discussion: Early recognition and surgical management of supernumerary nostrils are important to optimize functional andaesthetic outcomes. Detailed preoperative imaging is valuable to exclude intracranial or intranasal communication and to planreconstruction. Conclusion: Given its rarity, each reported case enriches current understanding of clinical variability and management strategies. Keywords: accessory nasal tract, case report, congenital anomaly, nasal development, pediatric plastic surgery, supernumerarynostril ## Introduction Congenital anomalies of the external nose are rare entities, oftenassociated with other craniofacial malformations. Among these,the supernumerary nostril represents a unique and exceedinglyrare developmental anomaly characterized by the presence of anadditional nostril-like structure, either communicating with thenasal cavity or existing independently. Since the first descriptionby Lindsay in 1906, approximately 60 cases have been reportedin the literature [1] . The embryological mechanism is not fullyunderstood but is thought to involve aberrant development ofthe lateral nasal processes or an accessory nasal placode duringearly embryogenesis (third to fourth weeks of gestation) [2] . Supernumerary nostrils are typically present at birth asa cosmetic deformity and may cause psychological distress.Rarely, they may result in functional impairment if associatedwith airway obstruction or recurrent infections. Early diagnosis B.P. Koirala Institute of Health Sciences, Dharan, Nepal Sponsorships or competing interests that maybe relevant to content are disclosedatthe end of this article. *Corresponding author. Address: B.P. Koirala Institute of Health Sciences, Dharan56700, Nepal. Tel.: +977 9818040566. E-mail: Dipeshkumarsingh2222@gmail.com(D.K. Singh). Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This is anopen access article distributed under the Creative Commons Attribution License 4.0(CCBY), which permits unrestricted use, distribution, and reproduction in any medium,provided the original work is properly cited. Annals of Medicine & Surgery (2026) 88:789–791Received 23 May 2025; Accepted 28 October 2025Published online 4 November 2025http://dx.doi.org/10.1097/MS9.0000000000004262 ### HIGHLIGHTS ● Rare Congenital Anomaly: Supernumerary nostril is anextremely rare congenital condition, with approximately60 cases reported globally, typically presenting as a uni -lateral accessory nostril. ● Case Overview: A 7-month-old female infant presentedwith a blind-ending, tubular accessory nostril above theleft nasal ala, without communication with the nasal cav -ity or associated anomalies. ● Imaging and Diagnosis: CT imaging confirme

FAQs

What was the main clinical finding in the infant case?

The infant had a tubular, skin-covered accessory nostril-like structure superior to the left nasal ala with a small distal opening.

What did contrast-enhanced CT show?

CT showed a blind-ending soft-tissue tubular tract with no communication to the nasal cavity or paranasal sinuses and no intracranial or bony involvement.

How was the supernumerary nostril managed and what were the outcomes?

The tract was completely excised and the left nasal ala was reconstructed with layered primary closure. Postoperative recovery was uneventful, with satisfactory cosmetic symmetry and no evidence of recurrence at 12 months.

Sep 29, 2026

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