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Heidarizadeh M, Sarrafzadeh A, Mohebiniya M, Jadidi S. Accidental finding prior to rhinoplasty: Rhinolith-A rare case report. Clin Case Rep 2024; 12:e8679. [PMID: 38510232 PMCID: PMC10950789 DOI: 10.1002/ccr3.8679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/23/2024] [Accepted: 02/07/2024] [Indexed: 03/22/2024] Open
Abstract
Through this case report, we review a rare radiographic finding within the nasal cavity and its histopathological findings in order to emphasize the importance of familiarizing oneself with all radiographic findings, regardless of their rarity.
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Affiliation(s)
- Mehdi Heidarizadeh
- Department of Oral and Maxillofacial Surgery, School of DentistryArak University of Medical SciencesArakIran
| | - Arash Sarrafzadeh
- Department of Oral and Maxillofacial Surgery, School of DentistryArak University of Medical SciencesArakIran
| | - Maryam Mohebiniya
- Department of Oral and Maxillofacial Radiology, School of DentistryArak University of Medical SciencesArakIran
| | - Soheila Jadidi
- School of DentistryArak University of Medical SciencesArakIran
- Student Research CommitteeArak University of Medical SciencesArakIran
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Tovmasyan AS, Polyaeva MY, Aleksanyan TA, Kolbanova IG, Kishinevskii AE, Mosin VV, Shvedov NV, Kryukova MS. [Rhinolith - diagnosis and treatment features]. Vestn Otorinolaringol 2023; 88:94-98. [PMID: 37450399 DOI: 10.17116/otorino20228803194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Exogenous foreign bodies enter the nasal cavity through the nostrils or in some cases through the choana and usually get stuck in the lower or middle nasal meatus. An alien body that has been in the nasal cavity for a long time serves as a nucleus around which calcium and magnesium salts, organic components, are deposited from the nasal secretions, and contributes to the formation of rhinolith (nasal stone, from Greek rhino - nose, lithos - stone). Endogenous material (thick mucous secret or a blood clot drying into the crusts, desquamated epithelium, an atypically located tooth, products of cellular lysis and necrosis of the mucous membrane) can also serve as a potential nucleus for salt deposition. Narrowing of the nasal passages due to the curvature of the nasal septum, hypertrophy of the nasal conchae, violation of mucociliary transport and inflammatory changes in the mucous membrane in chronic rhinitis or rhinosinusitis can lead to a delay in the mucous discharge in the nasal cavity, pH changes, excessive saturation of the secretion with crystalloids, initiate crystallization around the nucleus and deposition of salts. This article presents the results of clinical examination and surgical treatment of a patient with rhinolith formed by prolonged inhalation of construction dust.
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Affiliation(s)
- A S Tovmasyan
- Sverzhevsky Scientific Research Clinical Institute of Otorhinolaryngology of the Department of Health of the City of Moscow, Moscow, Russia
| | - M Yu Polyaeva
- Sverzhevsky Scientific Research Clinical Institute of Otorhinolaryngology of the Department of Health of the City of Moscow, Moscow, Russia
| | - T A Aleksanyan
- Sverzhevsky Scientific Research Clinical Institute of Otorhinolaryngology of the Department of Health of the City of Moscow, Moscow, Russia
| | - I G Kolbanova
- Sverzhevsky Scientific Research Clinical Institute of Otorhinolaryngology of the Department of Health of the City of Moscow, Moscow, Russia
| | - A E Kishinevskii
- Sverzhevsky Scientific Research Clinical Institute of Otorhinolaryngology of the Department of Health of the City of Moscow, Moscow, Russia
| | - V V Mosin
- Sverzhevsky Scientific Research Clinical Institute of Otorhinolaryngology of the Department of Health of the City of Moscow, Moscow, Russia
| | - N V Shvedov
- Sverzhevsky Scientific Research Clinical Institute of Otorhinolaryngology of the Department of Health of the City of Moscow, Moscow, Russia
| | - M S Kryukova
- Sverzhevsky Scientific Research Clinical Institute of Otorhinolaryngology of the Department of Health of the City of Moscow, Moscow, Russia
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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. [PMID: 31653637 PMCID: PMC6827740 DOI: 10.1136/bcr-2019-231989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2019] [Indexed: 11/04/2022] Open
Abstract
Rhinoliths are calcareous concretions of the nasal cavity formed around a nidus that may be endogenous (eg, dislodged tooth) or an exogenous foreign body (eg, plastic bead inserted by a child). Rhinoliths are often found incidentally on endoscopy or imaging to assess for other pathologies. The incidence is estimated to be 1 in 10 000 of all otolaryngology outpatient presentations, but this is likely to be an underestimate due to the often asymptomatic nature of this condition. We describe the unique case of a rhinolith that developed from a marijuana-filled balloon that the patient attempted to smuggle into a correctional facility. After inserting the package into his nostril, the patient then mistakenly believed it had been accidentally swallowed. Despite experiencing persistent symptoms of nasal obstruction and recurrent sinonasal infections, the marijuana package was only discovered 18 years after insertion following imaging for an unrelated indication.
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Affiliation(s)
- Murray Smith
- Otolaryngology, Head and Neck Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - Eugene Wong
- Otolaryngology, Head and Neck Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - Navid Ahmadi
- Otolaryngology, Head and Neck Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - Narinder Pal Singh
- Otolaryngology, Head and Neck Surgery, Westmead Hospital, Sydney, New South Wales, Australia
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Orhan K, Aksoy S, Avsever IH, Gündüz K. Incidental Findings in TMJ Imaging. IMAGING OF THE TEMPOROMANDIBULAR JOINT 2019. [PMCID: PMC7115005 DOI: 10.1007/978-3-319-99468-0_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
For years, the conventional imaging modalities are generally used in dental practice routine. They provide precious information about dentomaxillofacial region; they also have some limitations such as superimpositions, magnifications, distortions, and low-image quality. Because of these limitations, some pathologies, calcifications, and anatomical variations may be missed. Any findings on a radiographic image which are not related to the research areas of interest could be a description of “incidental findings.” Calcifications are one of these incidental findings. They are asymptomatic and also common in TMJ images. Although most of the calcifications require no treatment, correct identification will reduce further diagnostic assessments. Incidental findings on TMJ images were rare, while examining images for temporomandibular disorders and associated issues, it is important not only to examine the TMJ structures but also to look at the nearby anatomical features to check for evidence of incidental findings pathologies that may have mimicked signs and symptoms of TMJ disorders.
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Ng K, Fiani N, Peralta S. Suspected Rhinolithiasis Associated With Endodontic Disease in a Cat. J Vet Dent 2017; 34:282-287. [PMID: 28978272 DOI: 10.1177/0898756417733213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Rhinoliths are rare, intranasal, mineralized masses formed via the precipitation of mineral salts around an intranasal nidus. Clinical signs are typically consistent with inflammatory rhinitis and nasal obstruction, but asymptomatic cases are possible. Rhinoliths may be classified as exogenous or endogenous depending on the origin of the nidus, with endogenous rhinoliths reportedly being less common. This case report describes a suspected case of endogenous rhinolithiasis in a cat which was detected as an incidental finding during radiographic assessment of a maxillary canine tooth with endodontic disease. Treatment consisted of removal of the suspected rhinolith via a transalveolar approach after surgical extraction of the maxillary canine tooth.
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Affiliation(s)
- Kevin Ng
- 1 Perth Pet Dentistry, Balcatta, Western Australia, Australia
| | - Nadine Fiani
- 2 Dentistry and Oral Surgery, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Santiago Peralta
- 2 Dentistry and Oral Surgery, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
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Lop-Gros J, Gras-Cabrerizo JR, Bothe-González C, Montserrat-Gili JR, Sumarroca-Trouboul A, Massegur-Solench H. Fungus ball of the paranasal sinuses: Analysis of our serie of patients. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2015; 67:220-5. [PMID: 26708329 DOI: 10.1016/j.otorri.2015.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 08/31/2015] [Accepted: 09/09/2015] [Indexed: 12/28/2022]
Abstract
INTRODUCTION AND OBJECTIVES The fungus ball is the most frequent type of fungal rhino-sinusitis. The objective of this study is to analyze the clinical and surgical features of our patients. METHODS Retrospective analysis of 35 patients with fungus ball treated in our centre between 2006 and 2014. RESULTS Mean age was 55 years old. 49% were men and 51% women. 75% involved the maxillary sinus, whereas 25% involved the sphenoid. 69% of our patients showed microcalcifications in the CT study. All the patients were surgically treated, with no cases of recurrence. CONCLUSIONS Clinical manifestations of fungus ball are non-specific, therefore endoscopy and image study are mandatory. The definitive diagnosis is made by histopathological study of the lesion. Endoscopic sinus surgery is the treatment of choice, with opening of the diseased sinus and complete removal of the fungus ball. The frequency of complications is very low. No oral or topical antimycotic treatments are necessary.
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Affiliation(s)
- Joan Lop-Gros
- Sección de Rinología, Servicio de Otorrinolaringología, Hospital de la Santa Creu i de Sant Pau , Barcelona , España.
| | - Juan R Gras-Cabrerizo
- Sección de Rinología, Servicio de Otorrinolaringología, Hospital de la Santa Creu i de Sant Pau , Barcelona , España
| | - Carolina Bothe-González
- Sección de Rinología, Servicio de Otorrinolaringología, Hospital de la Santa Creu i de Sant Pau , Barcelona , España
| | - Juan R Montserrat-Gili
- Sección de Rinología, Servicio de Otorrinolaringología, Hospital de la Santa Creu i de Sant Pau , Barcelona , España
| | - Anna Sumarroca-Trouboul
- Sección de Rinología, Servicio de Otorrinolaringología, Hospital de la Santa Creu i de Sant Pau , Barcelona , España
| | - Humbert Massegur-Solench
- Sección de Rinología, Servicio de Otorrinolaringología, Hospital de la Santa Creu i de Sant Pau , Barcelona , España
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Girgis S, Cheng L, Gillett D. Rhinolith mimicking a toothache. Int J Surg Case Rep 2015; 14:66-8. [PMID: 26232741 PMCID: PMC4573408 DOI: 10.1016/j.ijscr.2015.06.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 05/17/2015] [Accepted: 06/27/2015] [Indexed: 11/22/2022] Open
Abstract
Rhinoliths are uncommon clinical entities. Toothache is not known to be the typical presenting symptom, and has yet to be reported. The pathogenesis of rhinolith remains unclear. Symptomatic lesions will require surgical removal. Although rare, rhinolith should be included as a differential diagnosis of atypical odontogenic pain in the absence of obvious clinical dental pathology.
Introduction A rhinolith is a calcified mass formed as a result of solidification of mucous foreign objects and gradual accretion of mineral salts. Toothache is not known to be the typical presenting symptom, and to our knowledge, has yet to be reported. Case report A 42-year old female referred by her general dental practitioner with a four month history of constant pain of the unrestored upper right central incisor tooth. Incidentally, she also gave a one year history of right-sided sinonasal congestion and intermittent blood stained rhinorrhea. Discussion Rhinoliths are uncommon and rarely encountered in clinical practice. This is due to the fact that they remain asymptomatic, and undetected for many years. They may present as incidental radio-opaque lesions in the nasal maxillary antrum on routine dental panoramic radiographs. Conclusion Rhinolith should be part of the differential diagnosis of atypical anterior maxillary dental pain in the absence of obvious clinical dental pathology.
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Affiliation(s)
- Sandra Girgis
- Homerton University Hospital NHS Foundation Trust, UK.
| | - Leo Cheng
- Homerton University Hospital NHS Foundation Trust, Barts Health NHS Trust, Mercy Ships, UK.
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Abstract
Oronasal fistula is defined as an abnormal duct, connecting the nasal with the oral cavity. We present an extremely rare case of oronasal fistula associated with rhinolithiasis. The particular case presents the unique feature of a palatal defect, being large enough to enable the in toto removal of the rhinolith. A 2-layer closure of the fistula was finally undertaken, by utilizing a vestibular and a palatal mucoperiosteal flap.
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Demirturk Kocasarac H, Celenk P, Erzurumlu Z, Kutlar G. Clinical and radiological aspects of rhinoliths: report of five cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 116:232-7. [PMID: 23849377 DOI: 10.1016/j.oooo.2013.05.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 05/08/2013] [Accepted: 05/25/2013] [Indexed: 11/27/2022]
Abstract
Rhinoliths are calcified masses in the nasal cavity caused by the deposition of nasal, lacrimal, and inflammatory mineral salts by accretion around an endogenous or exogenous nidus. Rhinoliths can be seen as incidental findings on panoramic radiography, although they typically appear blurred due to remaining outside the focus. Therefore, rhinoliths may be difficult to recognize; this difficulty can lead to misdiagnosis. Computed tomography (CT)/cone beam CT (CBCT) scans are generally necessary to define the precise location and to make a differential diagnosis. This article describes radiologic features of five cases of rhinoliths that were detected incidentally on panoramic radiographs. CT or CBCT images were obtained before removing the rhinoliths.
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Soft Tissue Calcifications and Ossifications. Oral Radiol 2014. [DOI: 10.1016/b978-0-323-09633-1.00028-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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13
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Kazikdas C, Gode S, Demirci M. Asymmetric adenoid hypertrophy in a patient with ipsilateral rhinolithiasis: an overlooked entity? J Surg Case Rep 2011; 2011:2. [PMID: 24971833 PMCID: PMC3649339 DOI: 10.1093/jscr/2011.12.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The aim of this article is to present a rhinolithiasis patient with a significant asymmetric adenoid hypertrophy on the same side and to describe possible mechanisms for this clinical entity. Careful nasopharyngoscopy after removal of rhinolith is mandatory not to overlook significant adenoid hypertrophy which may interfere with patients’ symptoms. The role of paranasal CT scan in the diagnosis of an asymmetric adenoid hypertrophy in rhinolithiasis patients is also discussed.
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Affiliation(s)
- C Kazikdas
- Ishakoglu Cayeli State Hospital, Rize, Turkey
| | - S Gode
- Ishakoglu Cayeli State Hospital, Rize, Turkey
| | - M Demirci
- Ishakoglu Cayeli State Hospital, Rize, Turkey
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A simple surgical approach for management of the rhinoliths: case report. J Oral Maxillofac Surg 2010; 69:1403-7. [PMID: 21195528 DOI: 10.1016/j.joms.2010.05.072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2009] [Revised: 03/15/2010] [Accepted: 05/18/2010] [Indexed: 11/21/2022]
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Chatziavramidis A, Kondylidou-Sidira A, Stefanidis A, Soldatou S. Longstanding rhinolith leading to anatomical alterations of the ipsilateral inferior nasal meatus and turbinate. BMJ Case Rep 2010; 2010:2010/nov18_1/bcr0720103155. [PMID: 22798515 DOI: 10.1136/bcr.07.2010.3155] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Rhinoliths consist of a central nidus with calcification resulting in calcareous concretions within the nasal cavity. They are uncommon in the literature despite a propensity particularly in children to insert foreign bodies into their nose and ears. We present the case of a 62-year-old woman with a longstanding undetected rhinolith with mild uncharacteristic symptoms. Radiographic examination revealed anatomical alteration of the inferior turbinate that was attributed to the long presence of the rhinolith in the nasal cavity. The management of the rhinolith and a review of the literature are presented.
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Sinolith in the ethmoid sinus: report of two cases and review of the literature. Eur Arch Otorhinolaryngol 2010; 267:1649-52. [PMID: 20596872 DOI: 10.1007/s00405-010-1321-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Accepted: 06/21/2010] [Indexed: 10/19/2022]
Abstract
We present two cases of sinolith in the ethmoid sinus. The first was a 52-year-old woman who complained of nasal dyspnea, postnasal drip and dry cough. Computed tomography (CT) showed a smooth-margined oval stone embedded in the middle meatus and occupying the bulla ethmoidalis, which was destroyed. The second was a 71-year-old man who had had repeated polypectomies. An oval calcified mass was revealed on CT in the anterior ethmoid sinus adjacent to the left lamina papyracea. All pertinent literature were reviewed and only one further case of ethmoid sinolith was encountered. The etiology, radiological features, differential diagnosis and treatment are discussed.
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The rhinolith-a possible differential diagnosis of a unilateral nasal obstruction. Case Rep Med 2010; 2010:845671. [PMID: 20592993 PMCID: PMC2892702 DOI: 10.1155/2010/845671] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Accepted: 05/16/2010] [Indexed: 11/17/2022] Open
Abstract
Rhinoliths are mineralised foreign bodies in the nasal cavity that are a chance finding at anterior rhinoscopy. Undiscovered, they grow appreciably in size and can cause a foul-smelling nasal discharge and breathing problems. Giant nasal stones are now a very rare occurrence, since improved diagnostic techniques, such as endoscopic/microscopic rhinoscopy, now make it possible to identify foreign bodies at an early stage of development. We report the case of a 37-year-old patient who, at the age of 5-6 years, introduced a foreign body, probably a stone, into his right nasal cavity. On presentation, he complained of difficulty in breathing through the right nostril that had persisted for the last 10 years. For the past four years a strong fetid smell from the nose had been apparent to those in his vicinity. Under general anaesthesia, the stone was removed in toto from the right nasal cavity. The possible genesis of the rhinolith is discussed, our case compared with those described in the literature, and possible differential diagnoses are considered.
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Gündüz K, Çelenk P, Alkan A. Intranasal radiopacities: incidental panoramic radiograph findings. Oral Radiol 2009. [DOI: 10.1007/s11282-009-0031-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sumbullu MA, Tozoglu U, Yoruk O, Yilmaz AB, Ucuncu H. Rhinolithiasis: the importance of flat panel detector-based cone beam computed tomography in diagnosis and treatment. ACTA ACUST UNITED AC 2009; 107:e65-7. [PMID: 19464647 DOI: 10.1016/j.tripleo.2009.02.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Accepted: 02/22/2009] [Indexed: 11/18/2022]
Abstract
Rhinolithiasis is a disease caused by deposition of organic and inorganic compounds in the nasal cavity. A nidus may be endogenous or exogenous. Rhinoliths are uncommon and often an asymptomatic condition diagnosed accidentally during a routine examination; but sometimes they may cause complications such as unilateral nasal obstruction, fetid rhinorrhea, or epistaxis. This article describes a case of rhinolith involving a 21-year-old female. The flat panel detector-based cone beam computed tomography (FPD-CBCT) findings, differential diagnosis, and treatment in a case of rhinolith are presented.
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Affiliation(s)
- M Akif Sumbullu
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
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Daneshbod Y, Khademi B, Janfeshan K, Rasehki AR. Intraoral presentation of rhinolith. Otolaryngol Head Neck Surg 2008; 138:535-6. [DOI: 10.1016/j.otohns.2007.12.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2007] [Revised: 12/10/2007] [Accepted: 12/20/2007] [Indexed: 10/22/2022]
Affiliation(s)
- Yahya Daneshbod
- Departments of Surgical Pathology and Hematopathology, Dr Daneshbod Pathology Laboratory
| | - Bijan Khademi
- Departments of Otolaryngology and Radiology, Shiraz University of Medical Sciences
| | - Katayoun Janfeshan
- Departments of Surgical Pathology and Hematopathology, Dr Daneshbod Pathology Laboratory
| | - Ali Reza Rasehki
- Departments of Otolaryngology and Radiology, Shiraz University of Medical Sciences
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Rhinoliths causing palatal perforation: case report and literature review. ACTA ACUST UNITED AC 2007; 104:e42-6. [PMID: 17942340 DOI: 10.1016/j.tripleo.2007.05.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Revised: 05/16/2007] [Accepted: 05/17/2007] [Indexed: 11/21/2022]
Abstract
Rhinoliths are calcified masses formed within the nasal cavity because of the solidification of mucus, debris, or foreign objects by gradual accretion of mineral salts. They are mostly asymptomatic and incidentally diagnosed, although some patients may complain of nasal discharge and obstruction. Ulceration of the nasal mucosa, facial swelling, and bone destruction are less frequently observed but bring about difficulties for differential diagnoses with several pathologic entities. This article presents a case of a 54-year-old woman with a rhinolith causing palatal perforation, focusing on the diagnostic process and histopathologic characteristics.
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