The unilateral nasal symptom should trigger a treating physician to a certain diagnosis. The differential
diagnosis includes foreign body, rhinolith and tumour. The chronicity of symptom helps a lot with the diagnosis.
Foreign body for example, tends to present with positive history of insertion, mainly by children or the acute
symptom of local infection. In the presence of prolonged symptom, rhinolith should be suspected especially when
the patient presents with pathognomonic nasal obstruction with foul smelly discharge. A referral should be made
for a nasoendoscopy evaluation whenever a rhinitis-like symptoms remain after a period of medical treatment for
allergy. We share a case of a missed diagnosis of a rhinolith after six years of symptoms.