Endoscopic Management of Rhinolithiasis: A Systematic Review

Abstract

Objective This study reviews the presentation, management, and outcomes of patients with rhinolithiasis. Data Sources An electronic database search of PubMed, SCOPUS, CINAHL, and the Cochrane Library was performed in accordance with the PRISMA 2020 updated guidelines for reporting systematic reviews. Review Methods Case reports and case series published from 2004 to 2020 were included. Data collected included patient demographics, clinical symptoms at presentation, diagnosis, treatment, complications, and follow‐up. Relevant descriptive statistics were computed using Microsoft Excel 2013 (Microsoft Corp). Results Fifty‐five case reports and five case series were included (n = 122). The majority were female (60.7%). The mean age was 29.4 years (range, 4‐80 years). The most common symptoms were rhinorrhea (81.1%), nasal obstruction (79.5%), nasal malodor (38.5%), and headache (27.9%). Computed tomography imaging was obtained in 109 (91.5%) cases. Concurrent rhinosinusitis (35.2%) and deviated nasal septum (28.7%) were commonly identified. Rhinoliths were commonly found in the right nostril (52.5%) and in between the inferior turbinate and nasal septum (26.9%). All rhinoliths were fully excised using endoscopic sinonasal surgery, accompanied by a septoplasty (9.2%). The nidus was identified in 27 (22.2%) patients. There were no recurrences or complications over an average follow‐up of 8.5 months (range, 0.25‐36 months). Conclusion Rhinolithiasis is an uncommon entity of the nasal cavity and should be suspected in patients with long‐standing unilateral nasal obstruction, rhinorrhea, and nasal malodor. Rigid nasal endoscopy and endoscopic sinonasal surgery are the most important methods for diagnosis and treatment, respectively.

Whole-Exome Sequencing of 21 Families: Candidate Genes for Early-Onset High Myopia

“…The main optical function of the crystalline lens is to transmit light, focusing it on the retina [65]. The retina is a layer of photoreceptor cells and glial cells that captures incoming photons from the lens, it can discern whether the perceived image is blurred or not, and it transmits the photons along neuronal pathways as both electrical and chemical signals for the brain to perceive a visual picture [66]. The choroid supplies the outer retina with nutrients and maintains the temperature and volume of the eye [67].…”

Retinal Artery Occlusion and Cardiovascular Disease: Risk Factors, Potential Pathophysiology, and Prognosis

“…When examining the retina, the macula is visible, which is an area with different pigmentation due to the presence of luteal pigment. The fovea is in the centre of the macula (16,20). The photoreceptors of the fovea constitute the central vision (17,20).…”

“…The fovea is in the centre of the macula (16,20). The photoreceptors of the fovea constitute the central vision (17,20). Between the retina and the sclera is the choroid, which is a vascular layer of the eye, supplying the outer third of the retina (21).…”