Kiessling Patrick, Hwang Peter, Chang Michael
Department of Otolaryngology-Head and Neck Surgery, Stanford Health Care, Stanford, CA, USA.
SAGE Open Med Case Rep. 2023 Oct 16;11:2050313X231207204. doi: 10.1177/2050313X231207204. eCollection 2023.
Rhinolithiasis is a rare clinical presentation and may be a diagnostic challenge, often mimicking other intranasal pathologies and difficult to differentiate based on imaging alone. We present the case of a 50-year-old patient with rhinolithiasis who presented with chronic left nasal obstruction and unilateral cyclic pain with foul discharge. After review of her imaging, she was initially misdiagnosed with an intranasal osteoma via telehealth and scheduled for surgical resection. Her true pathology of rhinolithiasis was subsequently identified and treated during an in-person pre-operative clinic visit. In this case report, we review the key characteristic elements of rhinolithiasis presentation, and in doing so, we reveal the limitations inherent to telehealth evaluations, and the considerations needed to be taken into account by providers evaluating intranasal lesions. Specifically, in-person assessment with a detailed endoscopy is critical as part of the complete workup of nasal cavity lesions.
鼻石症是一种罕见的临床表现，可能是一个诊断难题，常与其他鼻内病变相似，仅凭影像学检查难以鉴别。我们报告一例50岁鼻石症患者，表现为慢性左侧鼻塞、单侧周期性疼痛伴恶臭分泌物。在查看她的影像学检查后，她最初通过远程医疗被误诊为鼻内骨瘤，并计划进行手术切除。随后在术前门诊面诊时确定并治疗了她鼻石症的真实病理。在本病例报告中，我们回顾了鼻石症表现的关键特征要素，在此过程中，我们揭示了远程医疗评估固有的局限性，以及评估鼻内病变的医疗服务提供者需要考虑的因素。具体而言，作为鼻腔病变完整检查的一部分，进行详细的内镜检查的面诊至关重要。
