Long standing bilateral rhinolith remained for three decades, a rare case report

Background: Rhinolith is a rare condition explained as the mineralization of intra nasal foreign body. It can be asymptomatic and diagnosed incidentally or presents with nasal obstruction, mal-odor nasal discharge, facial pain, epistaxis and etc. it is usually unilateral. Bilateral rhinolith is extremely rare Case Presentation: A mentally retarded 34 year old female with history of unknown foreign body insertion into nasal cavities in childhood and complaints of bilateral nasal obstruction and nasal discharge for 30 years referred to ENT clinic. Nasal examination revealed bilateral mucopurulent discharge and a yellowish mass on the floor of left nasal cavity below the middle turbinate. CT Scan findings showed calcified masses in right and left nasal cavities and mucosal thickening of right maxillary sinus. Based on clinical history, physical examination and imaging findings the diagnosis was bilateral rhinolith. Rhinoliths were removed by endoscopic approach and all her symptoms relieved after surgery. Conclusion: Although it is rare, bilateral rhinoliths should be considered in differential diagnosis in patients with prolonged bilateral nasal obstruction and bilateral nasal discharge.