Rhinolithiasis: Mineralogical, chemical composition, clinical and radiological features of rhinoliths

Year 2019, Volume: 29 Issue: 1, 52 - 53, 10.03.2019

Taliye Çakabay Selin Üstün Bezgin Mahmut Cem Tarakçıoğlu Murat Koçyiğit Bilge Serin Keskineğe Safiye Giran Örtekin

Abstract

Objectives: This study aims to present our large series of rhinolithiasis and mineralogical, chemical composition and radiological features of rhinoliths to shed light into the etiology and pathogenesis of rhinolithiasis. Patients and Methods: A total of 35 patients 5 males, 30 females; mean age 24.7±15.0 years; range, 5 to 70 years with rhinolithiasis treated in our hospital between January 2011 and March 2016 were retrospectively analyzed. All patients were divided into four groups according to their age: 0-10, 11-30, 31-50, and 51-70 years. Data including age, gender, signs and symptoms, and accompanying nasal and extranasal pathologies were recorded. Mineralogical, chemical analysis of rhinoliths, nasal swab examination findings, and psychiatric consultation results were evaluated. Results: A statistically significant difference was found in symptoms between the groups according to the age group. Mineralogical, biochemical analysis was performed for 13 patients. The analysis revealed calcium carbonate and magnesium phosphate in six patients, magnesium carbonate and magnesium phosphate in three patients, magnesium oxalate and magnesium phosphate in two patients, and calcium oxalate and calcium phosphate in two patients. Normal bacterial flora was found in nasal swab culture results. Only one patient was diagnosed with learning disorder on psychiatric consultation. Conclusion: Rhinoliths are nasal stones which leads to long-standing nasal obstruction and discharge and nasal and oral malodor. Physicians should be aware unusual presentations, complicated conditions, and co-existing pathologies which can be encountered. A detailed evaluation by rigid nasal endoscopy and radiological evaluation with paranasal sinus computed tomography should be performed.

Keywords

Nasal stones, rhinolith, rhinorrhea

References

• Appleton SS, Kimbrough RE, Engstrom HI. Rhinolithiasis: a review. Oral Surg Oral Med Oral Pathol 1988;65:693-8.
• Aksungur EH, Binokay FB, Biçakçi K, Apaydin D, Oğuz M, Aydoğan B. A rhinolith which is mimicking a nasal benign tumor. Eur J Radiol 1999;31:53-5.
• Hadi U, Ghossaini S, Zaytoun G. Rhinolithiasis: a forgotten entity. Otolaryngol Head Neck Surg 2002;126:48-51.
• Karli R, Ak M, Karli A. A different placement of the stone; rhinolithiasis. Eur Rev Med Pharmacol Sci 2012;16:1541-5.
• Ezsiás A, Sugar AW. Rhinolith: an unusual case and an update. Ann Otol Rhinol Laryngol 1997;106:135-8.
• Carder HM, Hill JJ. Asymptomatic rhinolith: a brief review of the literature and case report. Laryngoscope 1996;76:524–30.
• Ozdemir S, Akbas Y, Görgülü O, Selçuk T, Sayar C. Rhinolithiasis: review of 21 cases. Am J Rhinol Allergy 2010;24:136-9.
• Royal SA, Gardner RE. Rhinolithiasis: an unusual pediatric nasal mass. Pediatr Radiol 1998;28:54-5.
• Balatsouras D, Eliopoulos P, Kaberos A, Economou C. Rhinolithiasis: an unusual cause of nasal obstruction. Rhinology 2002;40:162-4.
• Polson CJ. On rhinoliths. J Laryngol Otol 1943; 58:79-116.
• Morgan J. Rhinolithiasis. J Laryngol Otol 1957;71:331-8.
• Yuca K, Caksen H, Etlik O, Bayram I, Sakin YF, Dülger H, et al. The importance of rigid nasal endoscopy in the diagnosis and treatment of rhinolithiasis. Auris Nasus Larynx 2006;33:19-22.
• Atmaca S, Belet N, Sensoy G, Belet U. Rhinolithiasis: an unusual cause of sinusitis complicated with frontal osteomyelitis and epidural abscess. Turk J Pediatr 2010;52:187-90.
• Ozcan I, Ozcan KM, Ensari S, Dere H. Rhinolithiasis with a nasal polyp: a case report. Ear Nose Throat J 2008;87:150-1.
• Vink BW, van Hasselt P, Wormald R. A case of rhinolithiasis in botswana: a mineralogical, microscopic and chemical study. J Laryngol Otol 2002;116:1036-40.
• Kodaka T, Debari K, Sano T, Yamada M. Scanning electron microscopy and energy-dispersive X-ray microanalysis studies of several human calculi containing calcium phosphate crystals. Scanning Microsc 1994;8:241-56.
• Orhan K, Kocyigit D, Kisnisci R, Paksoy CS. Rhinolithiasis: an uncommon entity of the nasal cavity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:28-32
• Turk C, Knoll T, Petrik A, Sarica K, Skolarikos A, Straub M at al. Guidelines on Urolithiasis. European Association of Urology. 2015. Available from: https:// uroweb.org/wp-content/uploads/22-Urolithiasis_LR_ full.pdf
• Yaşar H, Ozkul H, Verim A. Rhinolithiasis: a retrospective study and review of the literature. Ear Nose Throat J 2009;88:24.