Rhinolithiasis Presenting with Long-Standing Unilateral Nasal Obstruction and Fetid Discharge: A Case Report

Background: Rhinolithiasis is an uncommon condition in which mineral salts deposit around an endogenous or exogenous nidus inside the nasal cavity, gradually forming a calcified mass. Because symptoms are nonspecific, it is often misdiagnosed as chronic rhinosinusitis. Case Presentation: A 45-year-old woman presented with 5 years of right-sided nasal obstruction with foulsmelling discharge, intermittent epistaxis, and headache. Nasal endoscopy showed a hard irregular mass, and CT of the paranasal sinuses confirmed a densely calcified lesion without bony erosion. The rhinolith was removed endoscopically under general anaesthesia. Outcome: Recovery was uneventful. On follow-up, the patient had complete symptom relief and healthy nasal mucosa with no recurrence at 6 months. Conclusion: Rhinolithiasis should be suspected in long-standing unilateral nasal obstruction with fetid discharge. Nasal endoscopy and CT help confirm the diagnosis and guide safe endoscopic removal.