DOI QR코드

DOI QR Code

Rhinolith: An incidental radiographic finding

  • Maheshwari, Nisha (Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, CWRU School of Dental Medicine Dental Clinic) ;
  • Etikaala, Badirinath (Alqua Health Care Center) ;
  • Syed, Ali Z. (Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, CWRU School of Dental Medicine Dental Clinic)
  • Received : 2020.05.23
  • Accepted : 2021.05.12
  • Published : 2021.09.30

Abstract

Rhinoliths are foreign bodies composed of mineralised deposits in the nasal cavity that are rarely encountered in routine dental practice. The current report presents a case of a 77-year-old female patient who visited a dental treatment centre for a routine dental check-up and prophylaxis. On the clinical examination, the patient did not report any breathing difficulty, nasal obstruction, or any form of discharge. Panoramic radiography showed a horizontally magnified radiopaque structure in the right nasal fossa region. Cone-beam computed tomography (CBCT) revealed a hyperdense entity with a laminated presentation in the right nasal fossa. The hyperdense entity was diagnosed as a rhinolith based on the radiographic findings. Although the patient was asymptomatic, a referral was made to an ear, nose, and throat surgeon for a further evaluation. This report highlights the importance of CBCT imaging in the diagnosis of soft-tissue calcifications.

Keywords

Acknowledgement

The authors would like to thank Dr. Kathryn Apotsos for allowing this case report to be published.

References

  1. Guneri P, Kaya A, Caliskan MK. Antroliths: survey of the literature and report of a case. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 99: 517-21. https://doi.org/10.1016/j.tripleo.2004.07.021
  2. Aksakal C. Rhinolith: examining the clinical, radiological and surgical features of 23 cases. Auris Nasus Larynx 2019; 46: 542-7. https://doi.org/10.1016/j.anl.2018.12.008
  3. Syed AZ, Hawkins A, Alluri LS, Jadallah B, Shahid K, Landers M, et al. Rare finding of Eustachian tube calcifications with cone-beam computed tomography. Imaging Sci Dent 2017; 47: 275-9. https://doi.org/10.5624/isd.2017.47.4.275
  4. Smith M, Wong E, Ahmadi N, Singh NP. A nose out of joint: first reported case of prison-acquired marijuana-based rhinolith. BMJ Case Rep 2019; 12: e231989. https://doi.org/10.1136/bcr-2019-231989
  5. Ayub-ur-Rehman, Muhammad MN, Moallam FA. Endoscopy in rhinolithiasis. J Coll Physicians Surg Pak 2012; 22: 601-3.
  6. Adib H, Natout MA, Zaytoun G, Hadi UA. Rhinolithiasis: a misleading entity. Allergy Rhinol (Providence) 2018; 9: 2152656718783596. https://doi.org/10.1177/2152656718783596
  7. Lin HC, Wang CH, Chen HC. Rhinolith from a long-ago insertion of a bead into the nasal cavity. Ear Nose Throat J 2015; 94: E36-7. https://doi.org/10.1177/014556131509400105
  8. Akkoca O, Tuzuner A, Demirci S, unlu C, Uzunkulaoglu H, Arslan N, et al. Patient characteristics and frequent localizations of rhinoliths. Turk Arch Otorhinolaryngol 2016; 54: 154-7.
  9. Pitt SK, Rout PG. Rhinoliths presenting during routine radiography: two cases. Dent Update 2000; 27: 505-7. https://doi.org/10.12968/denu.2000.27.10.505
  10. Ali M. Giant 'staghorn' rhinolith in a 15-year-old girl. BMJ Case Rep 2018; 11: e227587. https://doi.org/10.1136/bcr-2018-227587
  11. Syed AZ, Jadallah B, Uzcategui M, Shaik SM. CBCT diagnosis of a Stafne bone defect. J Mich Dent Assoc 2017; 99: 44-6.
  12. Syed AZ, Mupparapu M. Fossa navicularis magna detection on cone-beam computed tomography. Imaging Sci Dent 2016; 46: 47-51. https://doi.org/10.5624/isd.2016.46.1.47
  13. Syed AZ, Zahedpasha S, Rathore SA, Mupparapu M. Evaluation of canalis basilaris medianus using cone-beam computed tomography. Imaging Sci Dent 2016; 46: 141-4. https://doi.org/10.5624/isd.2016.46.2.141
  14. Yaroko A, Mohamad I, Hashim H. Rhinolith: an important cause of foul-smelling nasal discharge. Malays Fam Physician 2014; 9: 30-2.
  15. Aljfout Q, Saraireh M, Maita A. Rhinolith misdiagnosed as allergic rhinitis: case report. Electron Physician 2016; 8: 1880-3. https://doi.org/10.19082/1880
  16. Brehmer D, Riemann R. The rhinolith-a possible differential diagnosis of a unilateral nasal obstruction. Case Rep Med 2010; 2010: 845671.
  17. Bader W, Hiliopoulos P. Misdiagnoses of the rhinolith (author's transl). Laryngol Rhinol Otol(Stuttg) 1974; 53: 516-8.
  18. Patil K, Guledgud MV, Malleshi SN. Rhinolith. Indian J Dent Res 2009; 20: 114-6. https://doi.org/10.4103/0970-9290.49062
  19. Lahma J, Hejjouji R, Azzam I, Oujilal A, Essakalli L. Rhinolithiasis: about an observation of a rare condition. Pan Afr Med J 2018; 31: 78. https://doi.org/10.11604/pamj.2018.31.78.16570
  20. Yildirim N, Arslanoglu A, Sahan M, Yildirim A. Rhinolithiasis: clinical, radiological, and mineralogical features. Am J Rhinol 2008; 22: 78-81. https://doi.org/10.2500/ajr.2007.21.3112
  21. Dogan M, Dogan DO, Duger C, Polat S, Muderris S. Recurrent rhinolithiasis: a case report with review of the literature. West Indian Med J 2012; 61: 760-3.