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Case report
A nose out of joint: first reported case of prison-acquired marijuana-based rhinolith
  1. Murray Smith,
  2. Eugene Wong,
  3. Navid Ahmadi and
  4. Narinder Pal Singh
  1. Otolaryngology, Head and Neck Surgery, Westmead Hospital, Sydney, New South Wales, Australia
  1. Correspondence to Dr Eugene Wong; eugene.hl.wong{at}


Rhinoliths are calcareous concretions of the nasal cavity formed around a nidus that may be endogenous (eg, dislodged tooth) or an exogenous foreign body (eg, plastic bead inserted by a child). Rhinoliths are often found incidentally on endoscopy or imaging to assess for other pathologies. The incidence is estimated to be 1 in 10 000 of all otolaryngology outpatient presentations, but this is likely to be an underestimate due to the often asymptomatic nature of this condition. We describe the unique case of a rhinolith that developed from a marijuana-filled balloon that the patient attempted to smuggle into a correctional facility. After inserting the package into his nostril, the patient then mistakenly believed it had been accidentally swallowed. Despite experiencing persistent symptoms of nasal obstruction and recurrent sinonasal infections, the marijuana package was only discovered 18 years after insertion following imaging for an unrelated indication

  • ear, nose and throat/otolaryngology
  • otolaryngology / ENT

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  • Contributors All authors (MS, EW, NA, NPS) contributed to project conception and design, data collection, analysis of data and manuscript preparation. All authors have provided final approval for the manuscript for submission and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.