An International Journal of Otorhinolaryngology Clinics

Register      Login

VOLUME 11 , ISSUE 1 ( January-April, 2019 ) > List of Articles

CASE REPORT

Rhinolithiasis: An Unusual Misdiagnosed Entity

Puneeth S Nayak, Samanvaya Soni, Manasi B Manure, Tejaswini J Suresh

Citation Information : Nayak PS, Soni S, Manure MB, Suresh TJ. Rhinolithiasis: An Unusual Misdiagnosed Entity. Int J Otorhinolaryngol Clin 2019; 11 (1):24-26.

DOI: 10.5005/jp-journals-10003-1329

License: CC BY-NC 4.0

Published Online: 23-11-2020

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Aim: To assess the usefulness of endoscopy in the initial visit for nasal obstruction in the outpatient department. Background: Rhinolith as the name suggests is stone formation in the nose. They are formed by gradual deposition of calcium and magnesium salts in a manner to encrust an endogenous (thick mucus, blood clot, and ectopic teeth) or exogenous (seed and cotton fiber) nidus of origin. The first documented case of the pathology was reported by Barthdinin in 1654. Since it is a slow-growing entity, it remains asymptomatic for a long period and often comes to light with presentation of unilateral nasal obstruction, foul smelling nasal discharge, cacosmia, and epistaxis. With its ability to cause rhinosinusitis and bony erosions of septum, lateral nasal wall, and hard palate, they are typically misdiagnosed. Case description: A young patient came with the history of nasal obstruction on the left side for the past 1 year. There was an intermittent history of a yellow, thick, foul-smelling, blood-stained nasal discharge. Nasal endoscopic examination revealed an irregular, dark, stony mass covered with secretions confirming a rhinolith, which was removed piecemeal. Conclusion: Considered as the cause of nasal obstruction and cacosmia, and many a times present in patients who have nasal complaints, delay in the diagnosis and treatment should be avoided. Rigid nasal endoscopy is the most important method to be used in diagnosis and treatment of rhinolith. Clinical significance: Presentation of rhinolith and diagnostic dilemma are discussed in this article so as to enable the attending clinician to be aware of this still prevailing condition and to prevent complications, such as oroantral and oronasal fistulas, septal perforation, palatal perforation, bony destruction of the maxillary sinus, frontal osteomyelitis, and epidural abscess.


HTML PDF Share
  1. Appleton SS, Kimbrough RE, Engstrom HI. Rhinolithiasis: a review. Oral Surg Oral Med Pathol 1988;65(6):693–698. DOI: 10.1016/0030-4220(88)90012-6.
  2. Ozcan I, Ozcan KM, Ensari S, et al. Rhinolithiasis with a nasal polyp: a case report. Ear Nose Throat J 2008;87(3):150–151. DOI: 10.1177/014556130808700310.
  3. Kuczkowski J, Narozny W, Mikaszewski B, et al. Suppurative complications of frontal sinusitis in children. Clin Pediatr (Phila) 2005;44(8):675–682. DOI: 10.1177/000992280504400805.
  4. Kharoubi S. Revue générale sur les rhinolithiases. Ann Otolaryngol Chir Cervicofac 2008;125(1):11–17. DOI: 10.1016/j.aorl.2007.12.001.
  5. Davis O, Wolff A. Rhinolithiasis and maxillary antrolithiasis. Ear Nose Throat J 1985;64(9):421–426.
  6. Kumar S, Dev A, Kochhar LK. Living leech in nose and nasopharynx: an unusual foreign body. Indian Journal of Otolaryngology 1989;41(4):160–161.
  7. Seth S, Kumar H. Rhinolithiasis: A case report. J Clini Diagn Res 2011;5(4):856–858.
  8. Orhan K, Kocyigit D, Kisnisci R, et al. Rhinolithiasis: an uncommon entity of the nasal cavity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101(2):28–32. DOI: 10.1016/j.tripleo.2005.07.036.
  9. Hadi U, Ghossaini S, Zaytoun G. Rhinolithiasis: a forgotten entity. Otolaryngol Head Neck Surg 2002;126(1):48–51. DOI: 10.1067/mhn.2002.121018.
  10. Mustafa A, Nishori S. Rhinolith caused from the undetected foreign body: a case report. Kosova J Surg 2008;2(1):32–35.
  11. Mink A, Gati I, Szekely J. Nasolith removal with ultrasound lithotripsy. HNO 1991;39(3):116–117.
  12. Oguzhan D, Nurray BM, Osman KA. An unusual cause for nasal obstruction: rhinolithiasis. Bidder Tip Bilimleri Dergisi 2010;2(4):20–24.
  13. Shah F, George S, Reghunanden N. A case presentation of a large rhinolith. Oman Med J 2010;25(3):230–231.
  14. Atmacal S, Belet N, Sensoy G, et al. Rhinolithiasis: an unusual cause of sinusitis which is complicated with frontal osteomyelitis and epidural abscess. Turk J Pediatr 2010;52(2):187–190.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.