What Is a Rhinolith?

The word "rhinolith" is a medical term used to describe an acquired stone-like structure inside the nose. A rhinolith can also be referred to as a nasal calculus or a nose stone. These stones can cause symptoms such as pain, swelling, or abnormal nasal discharge. They are diagnosed on the basis of a physical exam, visualization of the nasal cavity with specialized scopes, or radiographic imaging of the entire head. Treatment focuses on removing the rhinolith and treating any underlying nasal infections.

In order to understand why a rhinolith might develop, it helps to understand the basics about the structure and function of the nose. Looking at a human face, the nose appears as a protuberance that ends in two openings referred to as the nares. They open into two symmetric chambers called the vestibules that are divided by the nasal septum; this opening extends upwards and backward, making the internal nasal cavity expand to a larger volume that its external appearance suggests. The nose is important because it warms and humidifies the air entering the human body and traveling to the lungs, and also filters this air by removing harmful particulate matter. In addition, the nose is important because the sinuses, which are hollow spaces present in the anterior face, drain into the nasal cavity.

Rhinoliths can develop in the internal nasal cavity. Typically a stone forms around a small structure, such as a piece of dried mucus or a foreign object inserted into the nose. Often the rhinolith is composed of deposits of minerals such as calcium. The stones can vary in size from a fraction of an inch to greater than an inch (2.54 cm) in diameter, and they preferentially form in the area where the sinuses drain their contents into the nasal cavity. Sometimes infection of the nose with different bacterial species can promote the growth of these nasal stones.

Symptoms experienced by a patient with a rhinolith can vary, but might include pain, swelling, abnormal nasal discharge, and a sensation of fullness. The affected patient might have a decreased sense of smell as a result of the obstruction caused by the stone. Most often the symptoms caused by this condition only affect one side of the nose.

Diagnosis of a rhinolith can be done using a number of different methods. In some cases, using a penlight to look up into the nares could help a doctor to make the diagnosis of a nasal stone. With other patients, doctors who specialize in diseases of the nose could use specialized scopes in order to visualize the nasal cavity more thoroughly. Other radiographic techniques, such as computed tomography (CT) scanning or x-rays, could also assist in diagnosis.

Treatment of a rhinolith focuses on removal of the stone. Sometimes the stone must be broken down into smaller component parts before it can be extracted. Often the nasal cavity is swabbed and cultured to see if there is any abnormal bacterial growth present, and if there is, patients are treated with appropriate antibiotic medications.