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.