Rhinoliths, also known as nasal calculi, are uncommon lesions that result from a chronic inflammatory response to complete or partial mineralized encrustation of intranasal foreign bodies. They are most commonly seen in children and cognitively impaired adults who insert foreign bodies into their nose. Less frequently, trauma, surgery and dental work, nasal packing material, and plugs of ointment may also promote the development of a rhinolith.
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Clinical presentation
Most rhinoliths ultimately produce clinical symptoms including unilateral purulent nasal discharge and nasal obstruction. There may be a marked lag between the initial insertion of the foreign body and the symptoms (as long as decades).
Radiographic features
Rhinoliths are usually unilateral and solitary, and most commonly between the inferior meatus and the nasal septum.
These lesions appear as a densely calcified mass in the nasal cavity, with displacement and expansion or destruction of the adjacent bony landmarks.
Some of the remote complications include perforation of the hard palate, bony destruction, erosion of the stone into the maxillary sinus, facial spasms, or septal perforation.
History and etymology
The first published report of a calcified foreign body in the nose appeared in 1654, in which Bartholini described a stone-hard foreign body that had grown around a cherry stone. The term rhinolith was first coined in 1845 to describe a partially or completely encrusted foreign body in the nose.
Differential diagnosis
- paranasal osteoma
- nasal tooth
- nasal foreign body
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