Thirty-Year-Old Rhinolith in a Female Adult at a Tertiary Institution.

Abstract

Rhinoliths are concrete salts of calcium, aluminum, and magnesium that form around exogenous or endogenous foreign bodies in the nasal cavity. Rhinoliths are most commonly asymptomatic and misdiagnosed. When symptomatic, they can present with nasal obstruction, foul breath, and bloody rhinorrhea. Rhinoscopy is the mainstay for rhinolith diagnosis. Plain radiographs or computerized tomography (CT) imaging aids in rhinolith diagnosis to determine their proper orientation. The definitive treatment is removal via manual or endoscopic maneuvers. We report the case of a 32-year-old female who was diagnosed with nasal polyps by a general practitioner because of persistent left-sided nasal obstruction, foul breath, and rhinorrhea for 6 months. The rhinolith was diagnosed via nasendoscopy and CT tomography of the paranasal sinuses, and its removal was performed under general anesthesia with the aid of an endoscope. The procedure was uneventful. The index patient was asymptomatic for 30 years, and was misdiagnosed with nasal polyps by a general practitioner. To the best of our knowledge, this is the first reported case of a rhinolith at our center.