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An Impacted Rhinolith Following Head Trauma: A Case Report From Kilimanjaro, Tanzania.

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A rare case of rhinolithiasis, a nasal stone, developed after facial trauma. Diagnosis was confirmed via CT scan, and endoscopic removal was successful, resolving symptoms like nasal obstruction and foul odor.

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Area of Science:

  • Otolaryngology
  • Medical Imaging

Background:

  • Rhinolithiasis, the formation of a nasal calculus, is an uncommon condition.
  • Symptoms can be non-specific and mimic other sinonasal pathologies, delaying diagnosis.

Purpose of the Study:

  • To report a case of rhinolithiasis presenting with chronic, obstructive symptoms following facial trauma.
  • To highlight the diagnostic utility of endoscopic examination and CT imaging in managing rhinolithiasis.

Main Methods:

  • A 38-year-old male with a history of motor vehicle accident and subsequent unilateral nasal symptoms underwent diagnostic nasal endoscopy.
  • Computed tomography (CT) scan was utilized to characterize the nasal lesion and associated sinonasal anatomy.
  • Surgical removal of the calcified mass was performed using rigid endoscopic techniques under general anesthesia.

Main Results:

  • Endoscopic examination revealed a stony hard, calcified mass obstructing the posterior nasal cavity.
  • CT scan confirmed a radio-opaque lesion with significant calcification, deviating the nasal septum, and identified a mucus retention cyst.
  • Complete endoscopic removal of the rhinolith in piecemeal fashion was achieved, leading to symptom resolution.

Conclusions:

  • Rhinolithiasis, though rare, should be considered in patients with chronic unilateral nasal symptoms, especially after trauma.
  • Nasal endoscopy and CT scanning are crucial for accurate diagnosis and surgical planning of rhinolithiasis.
  • Endoscopic removal is an effective treatment modality for symptomatic rhinolithiasis.