Nasendoscopy for unusual nasal symptoms

Area of Science:

• Otolaryngology
• Rhinology
• Foreign Body Management

Background:

• Nasal obstruction is a common complaint, often attributed to septal deviation or chronic sinusitis.
• Foreign bodies in the nose are frequently encountered in pediatric populations, but less commonly present in adults.
• Rhinoliths, though rare, can cause chronic nasal symptoms and require surgical removal.

Observation:

• A 20-year-old female presented with a 2-year history of left-sided nasal blockage.
• Anterior rhinoscopy revealed leftward septal deviation; septoplasty was planned.
• Intraoperative findings included a deviated septum and a posterior rhinolith in the left nostril.

Findings:

• The rhinolith was successfully removed, revealing an adequate nasal airway.
• Septoplasty was ultimately not required due to the resolution of obstruction post-rhinolith removal.
• The patient recalled inserting a pen cover into her nose approximately 10 years prior, which was not identified at that time.

Implications:

• This case highlights the potential for overlooked foreign bodies to form rhinoliths, leading to chronic nasal obstruction in adults.
• It underscores the importance of thorough nasal examination and patient history, even for seemingly minor childhood incidents.
• Prompt diagnosis and management of rhinoliths can prevent the need for more extensive surgical procedures like septoplasty.