Thursday, June 11, 2009

Rhinolith


21 year old male presented to ENT specialist complaining nasal mass and nasal block. Patient was reffered for CT scan of para nasal sinuses. Fig a and b shows curvilinear calcific density lesion seen in the right nasal cavity between theinferior turbinate and nasal septum. No soft tissue associated with the lesion. The findings suggestive of rhinolith.

Rhinolith is calcareous concretions around calcinated intranasal foreign bodies within the nasal cavity. Patient may not always gives history of foriegn body insertion in to nasal cavity. It is usually found in the anterior part of the nasal cavity and is usually diagnosed on history and clinical examintion. In such a condition, radiological evaluation is needed for differential diagnosis and to detect any related complications. CT scan is useful in a posteriorly situated mass which may cause difficulties in diagnosis.
On CT scan, it appears as a homogenous, high-density lesion with smooth mineralization.The central portion of the lesion, which may contain organic material, may be of a somewhat lower density, or a foreign-body nidus may be seen. The most important differential diagnosis include haemangioma, osteoma, calcified polyps, enchondroma, dermoid, chondrosarcoma, osteosarcoma, syphilis and tuberculosis. The complications reported are sinusitis, septal perforation, palatal perforation, recurrent otitis media, and recurrent dacryocystitis.

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