Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA.
Otolaryngol Head Neck Surg. 2023 Jun;168(6):1338-1345. doi: 10.1002/ohn.230. Epub 2023 Jan 29.
This study reviews the presentation, management, and outcomes of patients with rhinolithiasis.
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.
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).
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).
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.
本研究回顾了鼻结石患者的临床表现、治疗方法和结局。
根据 PRISMA 2020 对系统评价报告的更新指南，对 PubMed、SCOPUS、CINAHL 和 Cochrane 图书馆的电子数据库进行了检索。
纳入 2004 年至 2020 年发表的病例报告和病例系列。收集的数据包括患者人口统计学资料、就诊时的临床症状、诊断、治疗、并发症和随访情况。使用 Microsoft Excel 2013（Microsoft Corp）计算相关描述性统计数据。
共纳入 55 例病例报告和 5 例病例系列（n=122）。大多数为女性（60.7%）。平均年龄为 29.4 岁（范围，4-80 岁）。最常见的症状是流涕（81.1%）、鼻塞（79.5%）、鼻腔异味（38.5%）和头痛（27.9%）。109 例（91.5%）患者进行了计算机断层扫描成像。同时存在鼻窦炎（35.2%）和鼻中隔偏曲（28.7%）。结石常见于右侧鼻腔（52.5%）和下鼻甲与鼻中隔之间（26.9%）。所有结石均采用鼻内镜鼻窦手术完全切除，同时行鼻中隔成形术（9.2%）。27 例（22.2%）患者确定了结石的核心。平均随访 8.5 个月（0.25-36 个月），无复发或并发症。
鼻结石是鼻腔的一种罕见疾病，对于长期单侧鼻塞、流涕和鼻腔异味的患者，应怀疑该病。硬性鼻内镜和鼻内镜鼻窦手术分别是诊断和治疗的最重要方法。
