A Hidden Culprit in the Nasal Cavity: A Case Report on Bilateral Rhinolithiasis

Rhinolithiasis is a rare condition characterized by the deposition of mineralized masses within the nasal cavity. These calcified deposits cause chronic unilateral nasal obstruction and malodorous discharge, often leading to misdiagnosis as chronic rhinosinusitis. This report presents the case of a 45-year-old woman who experienced persistent unilateral nasal obstruction and foul-smelling discharge for 5 years. Previous treatment for presumed chronic rhinosinusitis produced limited improvement. Subsequent nasal endoscopy and computed tomography revealed bilateral rhinoliths extending into the nasopharynx and oropharynx, with greater involvement on the left side. The patient underwent successful endoscopic removal, resulting in complete symptom resolution. This case highlights the importance of considering rhinolithiasis in the differential diagnosis of patients presenting with chronic unilateral or bilateral nasal complaints. Early identification followed by minimally invasive, endoscopy-guided surgical intervention enables effective management and prevention of potential complications.