A rhinolith () is a

stone In geology, rock (or stone) is any naturally occurring solid mass or aggregate of minerals or mineraloid matter. It is categorized by the minerals included, its Chemical compound, chemical composition, and the way in which it is formed. Rocks ...

present in the

nasal cavity The nasal cavity is a large, air-filled space above and behind the nose in the middle of the face. The nasal septum divides the cavity into two cavities, also known as fossae. Each cavity is the continuation of one of the two nostrils. The nas ...

. It is an uncommon medical phenomenon, not to be confused with

dried nasal mucus Mucus (, ) is a slippery aqueous secretion produced by, and covering, mucous membranes. It is typically produced from cells found in mucous glands, although it may also originate from mixed glands, which contain both serous and mucous cells. It ...

. A rhinolith usually forms around the nucleus of a small exogenous

foreign body A foreign body (FB) is any object originating outside the body of an organism. In machinery, it can mean any unwanted intruding object. Most references to foreign bodies involve propulsion through natural orifices into hollow organs. Foreign b ...

blood clot A thrombus ( thrombi) is a solid or semisolid aggregate from constituents of the blood (platelets, fibrin, red blood cells, white blood cells) within the circulatory system during life. A blood clot is the final product of the blood coagulatio ...

secretion Secretion is the movement of material from one point to another, such as a secreted chemical substance from a cell or gland. In contrast, excretion is the removal of certain substances or waste products from a cell or organism. The classical mec ...

by slow deposition of

calcium Calcium is a chemical element; it has symbol Ca and atomic number 20. As an alkaline earth metal, calcium is a reactive metal that forms a dark oxide-nitride layer when exposed to air. Its physical and chemical properties are most similar to it ...

and

magnesium carbonate Magnesium carbonate, (archaic name magnesia alba), is an inorganic salt that is a colourless or white solid. Several hydrated and Base (chemistry), basic forms of magnesium carbonate also exist as minerals. Forms The most common magnesium car ...

and

phosphate Phosphates are the naturally occurring form of the element phosphorus. In chemistry, a phosphate is an anion, salt, functional group or ester derived from a phosphoric acid. It most commonly means orthophosphate, a derivative of orthop ...

salts. Over time, they grow into large irregular masses that fill the nasal cavity. They may cause pressure

necrosis Necrosis () is a form of cell injury which results in the premature death of cells in living tissue by autolysis. The term "necrosis" came about in the mid-19th century and is commonly attributed to German pathologist Rudolf Virchow, who i ...

of the

nasal septum The nasal septum () separates the left and right airways of the Human nose, nasal cavity, dividing the two nostrils. It is Depression (kinesiology), depressed by the depressor septi nasi muscle. Structure The fleshy external end of the nasal s ...

or lateral wall of nose. Rhinoliths can cause nasal obstruction,

epistaxis A nosebleed, also known as epistaxis, is an instance of bleeding from the nose. Blood can flow down into the stomach, and cause nausea and vomiting. In more severe cases, blood may come out of both nostrils. Rarely, bleeding may be so significan ...

headache A headache, also known as cephalalgia, is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of Depression (mood), depression in those with severe ...

sinusitis Sinusitis, also known as rhinosinusitis, is an inflammation of the mucous membranes that line the sinuses resulting in symptoms that may include production of thick nasal mucus, nasal congestion, facial congestion, facial pain, facial pressure ...

and epiphora. They can be diagnosed from the history with unilateral foul-smelling blood-stained nasal discharge or by anterior

rhinoscopy A rhinoscope (or nasoscope) is a thin, tube-like instrument used to examine the inside of the nose. A rhinoscope has a light and a lens for viewing and may have a tool to remove tissue. Types Rhinoscopy is performed by two procedures. * Anterio ...

. On probing, the probe can be passed around all its corners. In both CT and MRI a rhinolith will appear like a radiopaque irregular material. Small rhinoliths can be removed by a foreign body hook; large rhinoliths can be removed either by crushing with Luc's forceps or by Moore's lateral rhinotomy approach.

Signs and symptoms

Rhinoliths present as a unilateral nasal obstruction. Foul-smelling, blood-stained discharge is often present.

Nosebleed A nosebleed, also known as epistaxis, is an instance of bleeding from the nose. Blood can flow down into the stomach, and cause nausea and vomiting. In more severe cases, blood may come out of both nostrils. Rarely, bleeding may be so significa ...

and pain may occur due to the ulceration of surrounding mucosa.

Management

Rhinoliths are removed under general anaesthesia. Most can be removed through the anterior nares. Large ones need to be broken into pieces before removal. Some particularly hard and irregular ones may require lateral

rhinotomy Rhinotomy is mutilation, usually amputation, of the Human nose, nose. It was a means of judicial punishment throughout the world, particularly for sexual transgressions, but in the case of adultery often applied only to women. Ancient usage Th ...

References

External links

{{Respiratory pathology Medical signs Nose disorders