Hallazgo incidental de rinolito en fosa nasal izquierda en paciente adulto mayor: a propósito de un caso

Abstract

Background: Rhinolithiasis is a rare condition, with only 600 documented cases worldwide, with no record in Ecuador. Its incidence is estimated at approximately 1 case per 10,000 patients receiving otorhinolaryngologic care. Rhinoliths, formed by calcifying mineral substances inside the nose, may manifest clinically asymptomatic, going unnoticed for several years. However, there may also be symptoms such as unilateral nasal obstruction, unilateral purulent nasal discharge, unpleasant nasal odor, epistaxis, and severe headache, which can be confused with the symptoms of rhinosinusitis. These rhinoliths are usually unilateral and located in the nasal cavity. Diagnosis is made by nasal endoscopy and confirmed by imaging studies such as X- rays and CT scans. Primary treatment consists of surgical removal of the rhinoliths. Due to the rarity of this disease, a high degree of clinical suspicion is required for its detection and timely diagnosis. Case description: An 83-year-old female patient, presenting with symptoms of severe headache and right unilateral ocular pain of two months of evolution, was misdiagnosed with scleritis in the right eye, then attending the neurology area, where a CT head was requested, incidentally finding pathology of turbinates, with the presence of a mass in the floor of the left nostril. She was referred to the otorhinolaryngology service and was diagnosed with a rhinolith; however, due to the patient's age and coexisting medical conditions, extraction was not performed. Instead, observation and follow-up were chosen. Conclusion: Rhinolithiasis is a rare medical condition. The importance lies in having a high clinical suspicion for early diagnosis and timely treatment.