Rhinolithiasis: A very late complication after dacryocystorhinostomy with rubber-gum and polyethylene stenting

To describe a rare case of rhinolith formation 21 years after dacryocystorhinostomy (DCR) with rubber gum and polyethylene tubing surgery. Interventional case report. A 23-year-old-woman underwent uneventful left DCR with rubber gum and polyethylene tubing for chronic dacryocystitis. Twenty-one years later, she presented with purulent rhinorrhea, nasal obstruction, and facial pain. Computed tomography revealed a radiopaque density in the left nasal cavity. A rubber gum foreign body embedded with granulation tissue and a huge rhinolith was removed endoscopically through the anterior nares. After surgery, the patient reported immediate and complete relief of symptoms. Rhinoliths can develop progressively several years after DCR as a result of foreign body reaction to rubber gum or polyethylene tubing. This rare complication should be ruled out in patients complaining of purulent rhinorrhea who underwent DCR with tubing before the early 1980s.