Rhinolith an interesting case report

From Otolaryngology Online


History:

Right sided nasal block - 2 years

Mild bleeding from right nose - 1 year

On examination:

Whitish firm mass seen occupying the entire right nasal cavity.

The was gritty on palpation.


Coronal CT scan of nose showing rhinolith


Axial CT scan of nose and sinuses showing rhinolith

Management:

Rhinolith was removed via lateral rhinotomy approach.

Procedure:

Incision: The incision is named after Moure (Moure's lateral rhinotomy). The incision is started from the inner extremity of the eyebrow, descending along the lateral wall of the nose over the naso labial fold. It is curved up to the alar margin. The classic Moure's incision should not extend into the vestibule of the nose. The advantage of this incision is that it can be extended above and below to facilitate better exposure of midface, anterior skull base and orbit. The incision heals with minimal scarring.

Soft tissue dissection: The dissection is deepened up to the level of bone, the soft tissue is mobilised from the underlying ethmoid bone, antromedial antral wall and nasal pyramid. This gives excellent access into the nasal cavity.



Rhinolith after removal