Rhinolithiasis: a retrospective study and review of the literature.
ABSTRACT We conducted a retrospective analysis of 18 cases of rhinolithiasis treated in our clinic between 1990 and 2004. Age, sex, locations, diagnostic methods, and surgical technique were analyzed. Diagnosis was made by clinical examination and radiologic methods. Anterior rhinoscopy was performed in all patients and endoscopic evaluation in 14 patients. Plain-film x-rays of the paranasal sinus were taken in all patients, and computed tomography was performed in 5 patients. All rhinoliths were in the inferior meatus-11 right and 7 left. Patients' complaints were unilateral, foul-smelling rhinorrhea and nasal obstruction. Five patients also had headache, and 2 had cleft lip and palate. Rhinoliths were removed under local anesthesia in 12 patients and under general anesthesia in 6. An anterior rhinoscopic approach was used in 4 patients and an endoscopic approach in 14. Four of the patients underwent additional procedures, such as septoplasty, endoscopic sinus surgery, and adenoidectomy. Rhinolithiasis should be suspected in every case with unilateral, foul-smelling rhinorrhea and nasal obstruction. The treatment of choice is surgical removal under local or general anesthesia.
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ABSTRACT: A 20-year-old woman who was fit and well presented with a history of left nasal blockage for 2 years. She was noted on anterior rhinoscopy to have nasal septal deviation towards the left. She was listed for septoplasty with the aim of relieving nasal obstruction. At operation she was found to have a mildly deviated septum to the left. There was also a rhinolith in the left nostril posterior to the deviated septum (figure 1). Following removal of the rhinolith, her nasal airway appeared adequate; hence, septoplasty was not performed. Postoperatively, the patient was pleased with the outcome. When the patient was shown the foreign body she recalled inserting a pen cover into her nose about 10 years previously (figure 2). When she presented to the Accident and Emergency department at that time she was told that there was no foreign body in her nose.Case Reports 01/2010; 2010.