Rhinolith a forgotten entity: our experience in remote hilly population of Uttarakhand


  • Chetan Bansal Department of ENT, Shri Guru Ram Rai Institute of Medical Sciences, Dehradun, Uttarakhand, India
  • V. P. Singh Department of ENT, Shri Guru Ram Rai Institute of Medical Sciences, Dehradun, Uttarakhand, India
  • Deeksha Nautiyal Department of ENT, Shri Guru Ram Rai Institute of Medical Sciences, Dehradun, Uttarakhand, India




Rhinolith, Calculi, Foreign body


Background: Rhinoliths are mineralized foreign bodies in the nasal cavity and are diagnosed based on the presenting illness and clinical examination. Giant nasal stones are very rare in occurrence, since improved diagnostic techniques now make it possible to identify foreign bodies at an early stage of disease. The aim of the study was to revisit this rare and forgotten clinical entity with the variations in presentation in the hilly population of uttarakhand and treatment revisited.

Methods: We report a case series of 33 patients with rhinoliths who presented to our institute over a period of 10 years, from January 2007 to January 2017.  

Results: Average age was 25.48 years (range: 5 years to 60 years). 19 were female and 14 male. The incident was reported by a family member/attendant in 12.1% of cases (4 cases), discovered following nasal symptoms in 84.84% (28 cases) and was incidentally discovered in 3.03% (1 case). Symptoms comprised rhinorrhea associated with unpleasant nasal odor in 30.3% of cases (10 cases), epistaxis in 15.1% (5 cases), symptoms of sinusitis in 18.12% (6 cases), ozena in 6% (2 cases)and nasal obstruction in 84.84% (28 cases). There was one case of massive bilateral rhinolith presenting with bilateral symptoms which required an open approach in today’s era whereas all other cases were managed endoscopically.

Conclusions: Although rhinoliths are a rare occurrence, attending doctors should be aware of this entity and should have a high index of suspicion in cases with progressive unilateral nasal obstruction, unilateral rhinorrhea, unilateral nasal bleeding. In rare cases, rhinolith should be kept in mind as a differential diagnosis and also in bilateral nasal symptoms also specially if the symptoms are long standing.


Özdemir S, Görgülü O, Akbaş Y, Selçuk T, Sayar H, Tarkan Ö. An unusual co-presentation of rhinolithiasis and squamous cell carcinoma in the nasal cavity. J Craniomaxillofac Surg. 2012;40(5):137-9.

Sudhakar S, Kumar BP, Prabhat MPV. Rhinolith: A Case Report and Review of Literature.Journal of Indian Academy of Oral Medicine and Radiology. 2010;22(3):165-7.

Polson CJ. On rhinoliths. J Laryngol Otol. 1943;58:79-116.

Balatsouras D, Eliopoulos P, Kaberos A, Economou C. Rhinolithiasis: an unusual cause of nasal obstruction. Rhinology. 2002;40:162-4.

Ezsiás A, Sugar AW. Rhinolith: an unusual case and an update. Ann Otol Rhinol Laryngol. 1997;106(2):135-8.

Kharoubi S. Rhinolithiasis associated with septal perforation a case report, Acta Otol Rhino Laryngologica Belgica. 1998;52(3):241-5.

Singh RK, Varshney S, Bist SS, Gupta N, Bhatia R, Kishor S. A case of rhinolithiasis. Online J Health Allied Scs. 2008;7(2):7-9.

Patil K, Guledgud MV, Malleshi SN. Rhinolith. Indian J Dent Res. 2009;20:114–6.

Hadi U, Ghossaini S, Zaytoun G. Rhinolithiasis: a forgotten entity.Otolaryngol Head Neck Surg. 2002;126:48-51.






Original Research Articles