A rhinolith forms around a small foreign body introduced into the nose, causing inflammation and pus secretion high in calcium and magnesium. This allows mineral salts to precipitate over time, forming a stony mass. Rhinoliths typically cause unilateral nasal obstruction, foul discharge, pain, and ulceration. They appear on examination as an irregular, stony hard mass and can be seen on imaging tests. Rhinoliths are usually removed surgically under general anesthesia.

1. Rhinolith
Stone formation in the nasal cavity

2. Aetiology
Rhinolith forms around the nucleus of a
small exogenous foreign body
Fb introduced into the nose gives rise to
acute or chronic inflammation of nasal
mucosa with consecutive suppuration
The putrid discharge must have high
content of calcium and magnesium
Mechanical obstruction Blocks outflow of
pus and mucus
The secretion must be exposed to current
of air this concentrates pus and mucus
Permits mineral salt to precipitate Giving
rise to incrustation

3. Clinicalfeatures
More common in adults
Unilateral nasal obstruction
Foul smelling discharge which is often
blood stained
Frank epistaxis
Ulceration of surrounding mucosa
causes neuralgic pain
 pressure necrosis of septum and
lateral wall of nose

4. Examination
Color
Grey, brown, greenish black
Surface
irregular
Probe test
stony hard feel between septum and
turbinates
Brittle and easily breaks off
Surrounded by granulation

5. Diagnosis
History
Probe test : probe can be passed
Around all its corner
X ray
CT
MRI
In both CT and MRI a rhinolith will
appear as radio opaque irregular
material
Anterior rhinoscopy

6. Treatment
Removed under general anesthesia
Removed through anterior nares
Small rhinolith Can be removed by
foreign body hook
Large rhinolith Is removed by
crushing with luc forceps or by
Moores lateral rhinotomy approach

7. Differential
diagnosis
Osteoma
Odontoma
Calcified nasal polyp
Chondrosarcoma
osteosarcoma