It is normal for mucus to be found in the nasal cavity. The mucosal lining of the nasal cavity that is continuous with the respiratory passages constantly secrete mucus for various reasons. This mucus is gradually passed out backwards into the throat where it is swallowed or forwards through the nasal opening. Sometimes mucus can remain within the nasal cavity where it become dry and hard. This is not abnormal either unless the nasal mucus repeatedly dries, becomes very hard and sometimes stones form in the nasal cavity.
Mucus Secretion in the Nose
Air enters through the nasal cavity on its way to the lungs. Within the nasal cavity, the air is slowed down, warmed and even filtered. Tiny hairs linings in the nasal cavity trap dust and microbes before it travels deeper down the respiratory passage. Mucus is secreted by the nasal mucosa and it helps with trapping the dust and microbes. It also moisturizes the nasal lining which would quickly dry up with the air moving past it. Nasal mucus also assists with the sense of smell and helps with overall nasal health.
Mucus is viscid (thick) secretion although it can vary in consistency to some degree, like the watery secretions that are excessive during the flu or common cold. As the mucus becomes thicker in consistency, compacted and dries up it forms crusts which are commonly referred to as ‘boogers’. It can be uncomfortable and people may blow their nose in order to remove it or sometimes pick their nose to remove it manually with their finger. This is normal. However, when the mucus dries and hardens it can cause complications.
Dried and Hard Mucus
Dried mucus is usually picked out or can be dissolved again with proper moisturizing of the nasal cavity. However, sometimes nasal mucus dries and remains lodged in the nose instead of draining backwards into the throat or forward out of the nose. Abnormal drying of the nasal mucus is caused by:
- Environmental conditions like dry or windy climates or where there is excessive dust in the air.
- Air conditioning or strong electric fans striking the face.
- Dehydration which reduces mucus secretion and makes it thicker.
- Breathing faster than normal can increase the movement of air.
- Nasal congestion usually due to excessive mucus prevents the mucus from draining and it may then dry within the nasal cavity.
- Dry nasal passages are also more common among tobacco smokers.
Usually mucus production is not excessive but sufficient to ensure that the nasal mucosa is moisturized, that dust and microbes can be trapped and that the sense of smell functions properly. Excessive mucus production as is seen with upper respiratory tract infections like rhinitis and sinusitis and eventually this mucus can dry and become very hard.
Hardening of Mucus
Mucus that dries does become harder than normal but sometimes it can become very hard, almost like small pebbles or large grains of sand. It is usually with extremes of the conditions mentioned above, like with very dry air and prolonged periods in air conditioning. During infections, pus can also be present in the nasal cavity and sometimes even blood which further contribute to the formation of abnormally hard mucus. It can injure the nasal cavity and cause pain and even bleeding from the nose since the nasal mucosa is so delicate.
However, this type of dry and hard mucus is not entirely abnormal even though uncommon. It can be averted by using a humidifier in very dry climates, frequently administering a saline nasal spray to moisten the mucosa and staying away from the environmental factors that can cause drying like air conditioning and an electric fan. Sometimes very hard crusts, especially when it contains blood or pus, can serve as a catalyst for the formation of a rhinolith.
What is a rhinolith?
A rhinolith is a hard mass that forms in the nose. It s not just hardened nasal mucus but arises when minerals like calcium, phosphate and magnesium deposit around a central core. This core, known as the nidus, is usually a blood clot that is located in the nose. The mineral salts form a hard outer covering forming a stone known as a rhinolith. The presence of a rhinolith further irritates the nasal cavity causing profuse mucus discharge and sometimes bleeding. The rhinolith can obstruct the nasal passages and cause damage to the nasal tissue.
What causes a rhinolith?
Rhinoliths arise when some substance in the nasal cavity acts as a “seed” (nidus) around which a hardened layer of mineral salts can be deposited. This can be a blood clot, dried pus, cotton wool balls, dust particles or some other small foreign body. Therefore it is more likely to arise after an infection, with inserting objects in the nose or being exposed to a very dusty environment. It is only when these foreign bodies cannot be expelled from the nasal cavity that a rhinolith may form.
Symptoms and Treatment
A rhinolith is a rare occurrence. A very small rhinolith may not cause symptoms. However, as it grows in size it can lead to complicates like a perforated septum. Sometimes it can perforate the palate. Over time granulation tissue may grow over the stone and form what is known as a granuloma. Large stones may even obstruct the nasal cavity. The only way to treat a rhinolith is to have it manually removed which should be done by a medical professional such as an otorhinolaryngologist (ENT specialist).
Most people are not aware that excessive drying of the nasal passages with hardening of the mucus can be such a problem. The nose in particular is often taken for granted until it becomes congested, bleeds or other conditions arise. However, it is constantly functioning in life to filter air and allow air to flow in and out of the body. While it has the necessary mechanisms to maintain its functions, it also need the proper care to ensure that complications such as dry and hard crusts and rhinoliths do not form.