RT Journal Article SR Electronic T1 Opening a dacryocystorhinostomy into the opposite nasal cavity in a case of hemiarhinia JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e245424 DO 10.1136/bcr-2021-245424 VO 15 IS 1 A1 Rachna Meel A1 Asha Samdani A1 Sahil Agrawal A1 Deepsekhar Das YR 2022 UL http://casereports.bmj.com/content/15/1/e245424.abstract AB Heminasal agenesis is an exceedingly rare congenital anomaly which is frequently associated with disorders of eye, lacrimal drainage system and face. At times, a proboscis may also be noted with this condition. Herein, we present a case of a 13-year-old boy who presented to us with heminasal agenesis with concomitant microphthalmos, leucomatous corneal opacity, blepharoptosis, dacryocystocoele and maxillary hypoplasia. The child underwent a modified transeptal external dacryocystorhinostomy with placement of a lacrimal stent. There was significant improvement of epiphora and discharged following surgery. Heminasal aplasia with dacryocystocoele is surgical challenge; however, a well thought out surgical approach can yield satisfactory outcomes.