Rhinolith mimicking a toothache

Endoscopic Management of Rhinolithiasis: A Systematic Review

OBJECTIVE

This study reviews the presentation, management, and outcomes of patients with rhinolithiasis.

DATA SOURCES

An electronic database search of PubMed, SCOPUS, CINAHL, and the Cochrane Library was performed in accordance with the PRISMA 2020 updated guidelines for reporting systematic reviews.

REVIEW METHODS

Case reports and case series published from 2004 to 2020 were included. Data collected included patient demographics, clinical symptoms at presentation, diagnosis, treatment, complications, and follow-up. Relevant descriptive statistics were computed using Microsoft Excel 2013 (Microsoft Corp).

RESULTS

Fifty-five case reports and five case series were included (n = 122). The majority were female (60.7%). The mean age was 29.4 years (range, 4-80 years). The most common symptoms were rhinorrhea (81.1%), nasal obstruction (79.5%), nasal malodor (38.5%), and headache (27.9%). Computed tomography imaging was obtained in 109 (91.5%) cases. Concurrent rhinosinusitis (35.2%) and deviated nasal septum (28.7%) were commonly identified. Rhinoliths were commonly found in the right nostril (52.5%) and in between the inferior turbinate and nasal septum (26.9%). All rhinoliths were fully excised using endoscopic sinonasal surgery, accompanied by a septoplasty (9.2%). The nidus was identified in 27 (22.2%) patients. There were no recurrences or complications over an average follow-up of 8.5 months (range, 0.25-36 months).

CONCLUSION

Rhinolithiasis is an uncommon entity of the nasal cavity and should be suspected in patients with long-standing unilateral nasal obstruction, rhinorrhea, and nasal malodor. Rigid nasal endoscopy and endoscopic sinonasal surgery are the most important methods for diagnosis and treatment, respectively.

Algorithm for Treatment of Supernumerary Nasal Tooth

ABSTRACT

The presence of a tooth in the nasal cavity is a rare condition. There is an even more rare association, which is the presence with the mineral's deposition and formation of rhinoliths. This report shows a case of rare nasal tooth associated with rhinolithiasis and describes its surgical treatment based on an algorithm. The diagnosis was made by endoscopy with the aid of computed tomography, followed by surgical endoscopy excision. The algorithm and the proposed treatment was successful in its execution and the patient presents no complaints or complications at 3 years after surgery.

Large Rhinolith Mimicking Atypical Odontogenic Pain: Case Report and Brief Review of the Literature

Rhinoliths are rare calcified entities in the nasal fossa, frequently originating around a nidus near the midway point in the inferior meatus, where the passage is the narrowest. They can be clinically asymptomatic and undetected for years. In this study, we present a rare case of large rhinolith mimicking atypical odontogenic pain in a 40-year-old Caucasian female in the left nasal cavity. The lesion was detected in the CBCT and removed uneventfully.

Nasal Cavity Actinomycosis Mimicking Rhinolith

Actinomycosis is a subacute-to-chronic bacterial infection caused by filamentous, gram-positive, non-acid-fast, anaerobic-to-microaerophilic bacteria. It is characterized by continuous spread, suppurative and granulomatous inflammation, and formation of multiple abscesses and sinus tracts that may discharge sulfur granules. Although the most common clinical forms of actinomycosis are cervicofacial, involvement of the nose and paranasal sinuses are extremely rare. Furthermore, nasal cavity actinomycosis mimicking rhinolith has not been reported in the literature previously. This article reports a patient of nasal cavity actinomycosis causing symptoms similar to those of a rhinolith, which was successfully treated by surgical debridement and antibiotic therapy.