Abstract
The article describes a rare case of bilateral rhinolithiasis. The presence of a foreign body in the nasal cavity comprised 16 years. Pathogenetic aspects of the occurrence of the rhinoliths and their chemical composition are presented. Frequent recurrent acute exacerbations of chronic rhinitis, sensations of unpleasant smell, partial loss of smell, breathing problems due to nasal congestion and durable ineffectiveness of previous treatment triggered the patient to address to the clinic. CT revealed the presence of a foreign body on both sides of the nasal cavity. The patient underwent the surgery on bilateral rhinolithiasis with the application of precision technology and optical zoom. The nidus of rhinolith became plastic bullets of a toy gun. Intraoperative complications were not observed. The duration of hospitalization was 5 days. Follow-up evaluation by CT of the nasal cavity and paranasal sinuses in the period of 4 months after surgery revealed the absence of foreign bodies and nasal symptoms. Keywords: Foreign body, bilateral rhinolithiasis, nasal cavity, CT scan.
Highlights
The foreign body of the nasal cavity can be found frequently, especially in the practice of pediatric otorhinolaryngologist, but rhinoliths are always a rare finding, while occurrence of bilateral rhinoliths is a very rare episode [1].Rhinolith – mineralized mass, that results from the deposition of phosphoric acid and carbonate salt of calcium and mucus on the surface of a foreign body which localizes in the nasal cavity for a long period of time [2].Rhinolith is mainly detected unilaterally [3]
Considering the rarity of this pathology, we presented our own clinical observation – detection of bilateral rhinolith with existence of 16 years, and the nidus of which was the plastic bullets of a toy gun
The first reliably documented case report of a calcified foreign body in the nasal cavity was published by a Danish medical scientist Bartholin in 1654, when he described a foreign body encrusted with calcification and grown around a foreign body – a cherry bone
Summary
The foreign body (corpora aliena) of the nasal cavity can be found frequently, especially in the practice of pediatric otorhinolaryngologist, but rhinoliths are always a rare finding, while occurrence of bilateral rhinoliths is a very rare episode [1]. From the anamnesis (according to the parents) it turned out that the child in the age of 3, during playing a game, pushed in a foreign body in the nasal cavity which presumably was a bead or bullet of a toy gun. After the pre-operation preparation, the patient under the general endotracheal anesthesia underwent the surgical removal of foreign bodies (rhinolith) from the nasal cavity, as well as leftside conchectomy and the resection of anterior nasal spine with closed access using precision technology and optical enlargement. On the control CT of the nasal cavity performed four months later after the operation, the nasal passages were clean, free, without left lower nasal concha and any signs of foreign body presence (Fig. 5)
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