Iatrogenic Rhinoliths: Exercise Caution When Undertaking Palatal-Dental Impressions in the Cleft Patient with an Incompetent Palate

The inadvertent herniation of impression material from the oral to nasal cavities when undertaking a dental-palatal impression is a rare but recognized complication; however, it is largely avoidable, given appropriate attention to impression technique. The impression was performed in clinic using a light body silicone material; some material fractured during removal of the impression tray, and suction was used to eliminate the retained impression material. The child underwent a formal examination under anesthesia, whereby further fragments of impression material were extracted from the posterior nasal space; his subsequent recovery was uneventful, and he underwent an elective cleft lip repair at the age of 3 months. Macroscopically, the material was consistent with dental alginate; subsequent histologic analysis demonstrated that it was surrounded by laminated calcified concretions and colonies of Actinomyces-like bacteria. F.R.C.S. (Plast.) Consultant Cleft Surgeon, Spires Cleft Centre Oxford University Hospitals NHS Foundation Trust Headington, Oxford, U.K. Sandip Popat, B.D.S., Consultant in Restorative Dentistry, Spires Cleft Centre Oxford University Hospitals NHS Foundation Trust Headington, Oxford, U.K. Giles Kidner, B.D.S., Consultant Orthodontist, Spires Cleft Centre Oxford University Hospitals NHS Foundation Trust Headington, Oxford, U.K. Jane Sibley, R.G.N., R.S.C.N. Clinical Nurse Specialist, Spires Cleft Centre Oxford University Hospitals NHS Foundation Trust Headington, Oxford, U.K. Timothy E. E. Goodacre, B.Sc., F.R.C.S. Consultant Cleft Surgeon, Spires Cleft Centre Oxford University Hospitals NHS Foundation Trust Headington, Oxford, U.K. Disclosures: This article has neither been submitted nor presented elsewhere. Unusual foreign body in the nasal cavity of an adult with repaired cleft lip and palate.