Rhinolith

RHINOLITHSTONE IN THE NASAL CAVITY

BRIG ANWAR UL HAQ

Aetiology

• FB forms around the nidus

– Exogenous Foreign Body

– Blood clot

– Inspissated secretions

• Process

– Slow deposition of

• Calcium Salts

• Magnesium salt

Growth

• Large

• Irregular

• Pedunculated

• Into the nooks and corners

• May cause pressure necrosis of – Lateral wall

– Septum

– Hard Palate

Clinical Features

• More Common in Adults

• Unilateral Nasal Obstruction

• Nasal Discharge

– Foul Smelling

– Bloody

• Frank Epistaxis

• Neuralgic Pain

– Pressure

Examination• Colour

– Grey

– Brown

– Greenish black

• Surface– Irregular

• Feels with a probe– Stony hard

• Brittle

– Breaks off

• Granulations

• Complications– Septal, lat wall or Plaltal erosion

Diagnosis• History

• Anterior Rhinoscopy

• Anterior Rhinoscopy after decongestion

• Endoscopy

• X- Ray

• CT Scan

Diagnosis• History

• Anterior Rhinoscopy

• Anterior Rhinoscopy after decongestion

• Endoscopy

• X- Ray

• CT Scan

Treatment

Removal

Removal

• Without anaesthesia

• Local anaesthesia

• General anaesthesia

• Ant Rhioscopy

• Endoscopy

• Usually comes out in pieces - brittle

Methods of removal• forceps

Methods of removal

• hook

Nasal Myiasis

Nasal MyiasisMaggots in Nose

Atrophic rhinitis

FB in nose

Excessive nasal discharge

Poor mental health

Clinical features

• Discharge

– Foul smelling

–Bloody

• Face and lip swelling

• Maggots

– Intense destruction

• All nasal walls

• Fistula may form

Treatment

• Removal

• Chloroform

• Oil

• Water

CSF RHINORRHOEA

• SPONTANEOUS–SNEEZING

–STRAINING

• TRAUMATIC–IATROGENIC

–ACCIDENTAL

CSF RHINORRHOEA(WASHOUT SIGN)

FOVIA ETHMOIDALIS

SPHENOID SINUS CRIBRIFORM PLATE

CSF RHINORRHOEA(INTRATHECAL FLUORESCEIN)

REPAIR OF CSF FISTULA-ETHMOID

REPAIR OF CSF FISTULA

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