This document discusses various conditions that can result in stones or foreign bodies in the nasal cavity. It describes rhinoliths, which are stones that form around a nidus like a blood clot or inspissated secretions. Rhinoliths can grow large and irregularly, causing nasal obstruction, discharge, pain and other symptoms. Examination finds hard, irregular masses that break into pieces. CT scans are used for diagnosis. Rhinoliths are removed using various tools under local or general anesthesia. Myiasis and cerebral spinal fluid leaks into the nasal cavity from skull base fractures are also discussed.

1. RHINOLITH
STONE IN THE NASAL CAVITY
BRIG ANWAR UL HAQ

2. Aetiology
• FB forms around the nidus
– Exogenous Foreign Body
– Blood clot
– Inspissated secretions
• Process
– Slow deposition of
• Calcium Salts
• Magnesium salt

3. Growth
• Large
• Irregular
• Pedunculated
• Into the nooks and corners
• May cause pressure necrosis of
– Lateral wall
– Septum
– Hard Palate

4. Clinical Features
• More Common in Adults
• Unilateral Nasal Obstruction
• Nasal Discharge
– Foul Smelling
– Bloody
• Frank Epistaxis
• Neuralgic Pain
– Pressure

5. Examination
• Colour
– Grey
– Brown
– Greenish black
• Surface
– Irregular
• Feels with a probe
– Stony hard
• Brittle
– Breaks off
• Granulations
• Complications
– Septal, lat wall or Plaltal erosion

6. Diagnosis
• History
• Anterior Rhinoscopy
• Anterior Rhinoscopy after decongestion
• Endoscopy
• X- Ray
• CT Scan

7. Diagnosis
• History
• Anterior Rhinoscopy
• Anterior Rhinoscopy after decongestion
• Endoscopy
• X- Ray
• CT Scan

9. Treatment
Removal

10. Removal
• Without anaesthesia
• Local anaesthesia
• General anaesthesia
• Ant Rhioscopy
• Endoscopy
• Usually comes out in pieces - brittle

12. Methods of removal
• forceps

13. Methods of removal
• hook

15. Nasal
Myiasis

16. Nasal Myiasis
Maggots in Nose
Atrophic rhinitis
FB in nose
Excessive nasal discharge
Poor mental health

17. Clinical features
• Discharge
–Foul smelling
–Bloody
• Face and lip swelling
• Maggots
–Intense destruction
• All nasal walls
• Fistula may form

19. Treatment
• Removal
• Chloroform
• Oil
• Water

20. CSF RHINORRHOEA
• SPONTANEOUS
–SNEEZING
–STRAINING
• TRAUMATIC
–IATROGENIC
–ACCIDENTAL

24. CSF RHINORRHOEA
(WASHOUT SIGN)
FOVIA ETHMOIDALIS
SPHENOID SINUS CRIBRIFORM PLATE

25. CSF RHINORRHOEA
(INTRATHECAL FLUORESCEIN)

26. REPAIR OF CSF FISTULA-ETHMOID

27. REPAIR OF CSF FISTULA

28. THANK
YOU