Recovery of projectile through nose - an unusual presentation

Presentation of civilian gunshot injuries, especially to the face, have increased tremendously in the past decade in Karachi. Cranio-facial region when affected has a high mortality rate because projectile may lodge anywhere in the skull. Management of these gunshot wounds demands experience and expertise. A case of 21 year old male is reported, who sustained such an injury by a stray bullet, with the projectile entering from the lateral margin of the left nasal cavity and getting lodged within. Position of the projectile was assessed via series of X-rays. The projectile was removed under direct visualization from the nasal cavity in the Emergency Room. Endoscopic approach has been discussed for removal of deeper projectiles