Endoscopic Management of Rhinolithiasis: A Systematic Review

Author:

Nguyen Julia1ORCID,Omiunu Ariel1,Patel Rushi1,Patel Prayag1,Fang Christina H.2,Eloy Jean Anderson13456

Affiliation:

1. Department of Otolaryngology–Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USA

2. Department of Otorhinolaryngology–Head and Neck Surgery Montefiore Medical Center/Albert Einstein College of Medicine Bronx New York USA

3. Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey Rutgers New Jersey Medical School Newark New Jersey USA

4. Department of Neurological Surgery Rutgers New Jersey Medical School Newark New Jersey USA

5. Department of Ophthalmology and Visual Science Rutgers New Jersey Medical School Newark New Jersey USA

6. Department of Otolaryngology and Facial Plastic Surgery Saint Barnabas Medical Center–RWJBarnabas Health Livingston New Jersey USA

Abstract

AbstractObjectiveThis study reviews the presentation, management, and outcomes of patients with rhinolithiasis.Data SourcesAn electronic database search of PubMed, SCOPUS, CINAHL, and the Cochrane Library was performed in accordance with the PRISMA 2020 updated guidelines for reporting systematic reviews.Review MethodsCase reports and case series published from 2004 to 2020 were included. Data collected included patient demographics, clinical symptoms at presentation, diagnosis, treatment, complications, and follow‐up. Relevant descriptive statistics were computed using Microsoft Excel 2013 (Microsoft Corp).ResultsFifty‐five case reports and five case series were included (n = 122). The majority were female (60.7%). The mean age was 29.4 years (range, 4‐80 years). The most common symptoms were rhinorrhea (81.1%), nasal obstruction (79.5%), nasal malodor (38.5%), and headache (27.9%). Computed tomography imaging was obtained in 109 (91.5%) cases. Concurrent rhinosinusitis (35.2%) and deviated nasal septum (28.7%) were commonly identified. Rhinoliths were commonly found in the right nostril (52.5%) and in between the inferior turbinate and nasal septum (26.9%). All rhinoliths were fully excised using endoscopic sinonasal surgery, accompanied by a septoplasty (9.2%). The nidus was identified in 27 (22.2%) patients. There were no recurrences or complications over an average follow‐up of 8.5 months (range, 0.25‐36 months).ConclusionRhinolithiasis is an uncommon entity of the nasal cavity and should be suspected in patients with long‐standing unilateral nasal obstruction, rhinorrhea, and nasal malodor. Rigid nasal endoscopy and endoscopic sinonasal surgery are the most important methods for diagnosis and treatment, respectively.

Publisher

Wiley

Subject

Otorhinolaryngology,Surgery

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