Treatment of rhinolith
Small rhinoliths that are easily accessible can be removed by a foreign body hook in the office followed by anterior nasal packing if needed. Whereas large rhinolith needs to be removed under general anesthesia to avoid complications such as perforation of the nasal septum or the hard palate. Large rhinoliths can be removed either by crushing with Luc’s forceps or by Moore’s lateral rhinotomy approach with some bleeding to be expected. Also if the patient is a small child or mentally challenged, then removal under general anesthesia is preferable. Afterwards if significant raw area is visible in both medial and lateral nasal walls, then to prevent adhesions and synechiae, it is highly recommended to place a silastic splint for a few days. Unless bleeding is very little, anterior nasal packing is usually needed for 24–48 hours. The patient usually makes full recovery afterwards with resolution of symptoms. Nowadays, while endoscopic removal is usually employed, very rarely lithotripsy and lateral rhinotomy have to be considered where endoscopic option is not available