title: Rhinotillexomania: a rare cause of medial orbital wall erosion.
abstract: The authors report a rare case of medial orbital wall erosion with an orbital inflammatory mass and resultant lacrimal obstruction secondary to rhinotillexomania. A 67-year-old male with known history of compulsive nose picking (rhinotillexomania) sought treatment for complaints of watering in his OD. Examination revealed a blocked right inferior canaliculus. Nasal endoscopy showed a large nasal septal defect with multiple areas of crusting and bleeding. Hematologic investigations were normal. CT scan confirmed a large nasal septal and right medial orbital wall defect with an adjacent soft tissue mass in the medial orbit. Investigations ruled out systemic pathology. Histologic examination of medial orbital mass, sinus, and nasal mucosa revealed a reactive inflammatory infiltrate with surface Gram-positive cocci. The authors hypothesized that the patient had enlarged an existing nasal septal defect due to repetitive nose picking resulting in recurrent infection and inflammation of sinuses, leading to erosion of his medial orbital wall.
authors: *Department of Ophthalmology, University Hospital, University Hospitals of Coventry & Warwickshire NHS Trust, Clifford Bridge Road, Coventry, and †Department of Otorhinolaryngology, University Hospitals of Birmingham NHS Trust, Birmingham, United Kingdom.
authors: Deepa
authors: D
authors: Rathore
authors: Shahzada K
authors: SK
authors: Ahmed
authors: Harpreet S
authors: HS
authors: Ahluwalia
authors: Purnima
authors: P
authors: Mehta
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001521:Behavior Therapy; D003131:Combined Modality Therapy; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000150:complications*; D015818:Eye Infections, Bacterial / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D005131:Eye Injuries / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D061270:Nasal Septal Perforation / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D059085:Nasal Sprays; D009666:Nose; D009915:Orbit / Q000293:injuries*; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D007507:Therapeutic Irrigation; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D059085:Nasal Sprays