CBCT Reveals Undetected Rhinolith, Improves Patient Quality of Life

By: Jason G. Souyias, D.D.S.

Case Overview

A 56-year-old Caucasian female presented to our office to determine her options in implant reconstruction. Our interview and review of her medical and dental histories revealed her to be in good general health. At the time of our interview, she was a half pack per day smoker and was taking Lipitor®, Ambien®, estrogen, calcium and vitamin D supplements. The patient reported regularly having sinus infections limited to her right side and reported having an obstructed air flow of the right nasal pathway. As far back as she could remember, the patient had suffered from these problems.

A panoramic radiograph was taken in 2010 in another office. No sign of any nasal pathology or sinus pathology can be noted. A CBCT was ordered for implant planning. After taking a scan with the CS 9300 in our office, we were able to find pathology obstructing the right nasal passage.

Treatment Plan

The patient was referred to an otolaryngologist for diagnosis and treatment. Following removal of the rhinolith by the treating physician, the patient noticed immediate relief of the nasal obstruction and has not had a sinus infection since the removal. She has thanked our office numerous times for helping to improve her quality of life. She said, “It’s amazing to be able to breathe normally after so many years of problems.”


Three-dimensional CBCT imaging can provide a great deal of clinical information which would otherwise remain unseen in 2D radiographs. In this case, a prior panoramic radiograph had shown no sign of long-term obstructive nasal pathology, even though the rhinolith had been causing the patient trouble for many years. The CS 9300 very clearly displayed the rhinolith and facilitated collaborative care.

Improved quality of life is obviously a primary objective of almost any treatment plan, and repeated thanks from a relieved and satisfied patient is one of the most rewarding forms of feedback a clinician can receive. Had it not been for the high-quality scan from the CS 9300, this patient’s rhinolith might have gone undetected for even longer, subjecting the patient to the same cycle of breathing difficulties and sinus infections she’d been experiencing for years.