scholarly journals Bilateral Triple Concha Bullosa: A Very Rare Anatomical Variation of Intranasal Turbinates

2014 ◽  
Vol 2014 ◽  
pp. 1-2 ◽  
Author(s):  
Turhan San ◽  
Selma San ◽  
Emre Gürkan ◽  
Barış Erdoğan
Keyword(s):  
Paranasal Sinus ◽  
Anatomic Variation ◽  
Anatomical Variation ◽  
Middle Turbinate ◽  
Etiologic Factor ◽  
Lateral Nasal Wall ◽  
Concha Bullosa ◽  
Superior Turbinate ◽  
Negative Effect ◽  
Air Cells

Pneumatization of the intranasal turbinates or concha bullosa is an anatomic variation of the lateral nasal wall. Concha bullosa is defined as the presence of air cells in turbinates. It can be best diagnosed with paranasal sinus computed tomography. Concha bullosa is a possible etiologic factor for recurrent sinusitis due to its negative effect on paranasal sinus ventilation and mucociliary clearance. Concha bullosa is most commonly seen in the middle turbinate and less frequently in the inferior or superior turbinate. Pneumatization of all turbinates is very rare. To our knowledge, there are only two publications about a case with concha bullosa in all turbinates in the current literature. Here, we present a woman with bilateral pneumatization in all three intranasal turbinates.

scholarly journals Triple-Divided Concha Bullosa: A New Anatomic Variation

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Turhan San ◽  
Barış Erdoğan ◽  
Bülent Taşel
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Imaging Techniques ◽  
Anatomic Variation ◽  
Middle Turbinate ◽  
Anatomical Variations ◽  
Concha Bullosa ◽  
Paranasal Sinus Computed Tomography

In recent years, with the widespread use of imaging techniques such as paranasal sinus computed tomography (CT), many variations of nasal turbinates have been described. One of these variations known as concha bullosa (CB) is pneumatization of nasal turbinates. CB is the most frequently encountered anatomical variations of the middle turbinate. The term of septated concha bullosa has been described recently and it is an uncommon pneumatization anomaly of the middle turbinate. There has not been any study that correlates the number of septations and the presence of sinonasal pathologies. We hereby present a case of triple septated concha bullosa that has not been reported so far.

scholarly journals Large Doubly Septated Concha Bullosa: An Unusual Anatomic Variation

2009 ◽  
Vol 52 (3) ◽  
pp. 129-131 ◽  
Author(s):  
Aleksandar Perić ◽  
Svjetlana Matković-Jožin ◽  
Nenad Baletić
Keyword(s):  
Nasal Obstruction ◽  
Rare Case ◽  
Anatomic Variation ◽  
Middle Turbinate ◽  
Lateral Nasal Wall ◽  
Middle Meatus ◽  
Anatomic Variations ◽  
Concha Bullosa ◽  
Frontal Recess ◽  
Different Sources

Partial or total pneumatization of the middle turbinate is called concha bullosa. It’s one of the most common anatomic variations of the lateral nasal wall. The exact reason of such pneumatization is not known. It can originate from the frontal recess, middle meatus, sinus lateralis or, less frequently, from the posterior ethmoid cells. Concha bullosa remains usually asymptomatic. However, an extensively pneumatized middle turbinate may constitute space-occupying mass, and thus, it may cause nasal obstruction. We report an extremely rare case of a patient with a large, doubly septated concha bullosa with four different sources of aeration.

scholarly journals Anatomical variation of middle concha and its clinical correlates: a study among patients attending North Bengal Medical College

2015 ◽  
Vol 04 (02) ◽  
pp. 86-92
Author(s):  
Raktim Bandyopadhyay ◽  
Romy Biswas ◽  
Sharmistha Bhattacherjee ◽  
Sankar Prasad Kabiraj ◽  
lndrajit Gupta
Keyword(s):  
Anatomical Variation ◽  
Lateral Nasal Wall ◽  
Concha Bullosa ◽  
Cross Sectional ◽  
Anatomical Variant ◽  
Clinical Correlates ◽  
Medical College ◽  
Osteomeatal Complex ◽  
Air Cells ◽  
North Bengal

Abstract Background and aims: Lateral nasal wall of each nasal cavity provides the final common pathway of drainage of the muco-ciliary clearance of frontal, maxillary and anterior ethmoidal air cells. Anatomical variant like Concha Bullosa may obstruct the muco­ ciliary clearance thmugh osteomeatal complex and cause rhino sinusitis. The objectives were to find out the anatomical variation of middle concha and its clinical correlates with variation of middle concha. Methods: The present study was a descriptive, hospital based cross sectional study carried out in the outpatient departments of North Bengal Medical College & Hospital among 15 years and above patients. Coronal CT scan of paranasal sinus and orbit region was done. Data was collected with the help of semi structured predesigned and pretested questionnaire. Results: Of the 44 study patients, 15.9% had Concha Bullosa, 11.36% had paradoxical middle concha. Dimensions of right and left concha were also studied. 77.3%, 59.1% and 47.7% had sneezing, rhinorrhoea and headache respectively. Conclusion: The harmony of mucociliary clearance and obstruction free osteomeatal complex is the key factor for ventilation and drainage of maxillary, fmntal and anterior ethmoidal air cells.

Middle Turbinate Headache Syndrome

1993 ◽  
Vol 7 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Ari J. Goldsmith ◽  
Gerald D. Zahtz ◽  
Arsen Stegnjajic ◽  
Mark Shikowitz
Keyword(s):  
Inflammatory Disease ◽  
Facial Pain ◽  
Clinical Presentation ◽  
Middle Turbinate ◽  
Trigger Points ◽  
Sensory Innervation ◽  
Lateral Nasal Wall ◽  
Concha Bullosa ◽  
Headache Syndrome ◽  
Sinus Mucosa

Sinus headaches are attributed to inflammatory disease of the sinus mucosa or ostium. In 1948 H.G. Wolff first recognized that sinus headaches may occur in the absence of inflammatory sinusitis, and may be due to contact between strategic “trigger points” in the sinonasal passages. Since this time there have been sporadic reports of headaches and facial pain due to an enlarged middle turbinate contacting either the septum or lateral nasal wall. It is theorized that an enlarged middle turbinate, most commonly due to pneumatization (concha bullosa), can contact the septum or lateral nasal wall and give headaches referred to the ophthalmic division of the trigeminal nerve, the main sensory innervation of the anterior middle turbinate. Middle turbinate headache syndrome is reviewed, with attention to pathophysiology, clinical presentation, and treatment. Eight cases of middle turbinate headache will be presented in support of this clinical entity. We hope to alert the clinician to a relatively unknown source of recurrent headaches, that may be readily treated by otolaryngologists.

Concha bullosa: reducing middle meatal adhesions by preserving the lateral mucosa as a posterior pedicle flap

2004 ◽  
Vol 118 (10) ◽  
pp. 799-803 ◽  
Author(s):  
Elizabeth A.W. Sigston ◽  
Claire E. Iseli ◽  
Tim A. Iseli
Keyword(s):  
Middle Turbinate ◽  
Pedicled Flap ◽  
Lateral Nasal Wall ◽  
Consecutive Series ◽  
Concha Bullosa ◽  
Modified Technique ◽  
Pedicle Flap ◽  
Simple Modification ◽  
Mucosal Flap

Background: Concha bullosa, an extensively pneumatized middle turbinate, may obstruct the paranasal sinuses. Messerklinger’s partial lateral turbinectomy is commonly used to debulk the concha bullosa, leaving a raw surface with the potential for adhesions.Materials and methods: A modified technique of partial lateral turbinectomy is described. A posterior pedicled mucosal flap covers the inferior raw surface of the medial lamella of the middle turbinate. Three-month follow up of a consecutive series is compared with concurrent controls. Results: Two (7 per cent) of 28 posterior pedicled flap and four (21 per cent) of 19 traditional partial lateral turbinectomies developed mild middle meatal adhesions (p = 0.011). Posterior pedicled flap reduced the need for post-operative cleaning of the middle meatus.Conclusion: The posterior pedicled mucosal flap is a simple modification to partial lateral turbinectomy that covers the raw surface facing the lateral nasal wall, significantly reducing adhesions and speeding recovery.

scholarly journals Anatomical variations in patients with chronic sinusitis

2018 ◽  
Vol 4 (2) ◽  
pp. 428 ◽  
Author(s):  
Pragadeeswaran Kumarasekaran ◽  
Rajprakash Dharmapuri Yadhava krishnan ◽  
Gurumani Sriraman
Keyword(s):  
Nasal Septum ◽  
Chronic Sinusitis ◽  
Anatomical Variation ◽  
Middle Turbinate ◽  
Anatomical Variations ◽  
Uncinate Process ◽  
Sinus Surgery ◽  
Concha Bullosa ◽  
Deviated Nasal Septum ◽  
Anatomical Variant

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">C</span><span lang="EN-IN">hronic sinusitis is repeated bouts of acute infection or persistent inflammation of the sinuses. The range of anatomic variants that can interfere with the mucociliary drainage of osteomeatal complex including concha bullosa, deviated nasal septum, uncinate process variations, ethmoid bulla, paradoxical middle turbinate, agger nasi and Haller cells. This is also important in surgeon point of view to know about detail knowledge of lateral nasal wall, paranasal sinuses, surrounding vital structures and anatomical variation. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Observational case series study in which 90 cases of chronic rhinosinusitis patients attending the ENT outpatient department from November-2015 to November-2016 in Shri Sathya Sai Medical college and Hospital, who had chronic sinusitis for more than three months duration not responding to the medical line treatment and who are willing to undergo functional endoscopic sinus surgery are studied and statistically analysed.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">In our study we found anatomical variation in 93% of chronic sinusitis patients. In our study it was observed that 52% of patients with two anatomical variation, 41% patients presented with single anatomical variation and 7% patients presented with no anatomical variation. In our study deviated nasal septum was the most common anatomical variant noted followed by unilateral concha bullosa, medialized uncinate process, paradoxical middle turbinate, haller cell and agger nasi. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">In our study it was concluded that presence of anatomical variations is common in patients with chronic sinusitis. Presence of more than one anatomical variations significantly contributes to disease process.<strong> </strong>Deviated nasal septum is the most common anatomical variation in our study followed by concha bullosa, medialized uncinate process.</span></p>

scholarly journals CT Evaluation of Anatomical Variations in Osteomeatal Complex in Patients with Deviated Nasal Septum

2016 ◽  
Vol 21 (2) ◽  
pp. 90-93
Author(s):  
Mirza Aneesa ◽  
Sajad Majid Qazi ◽  
Aijazul Haq
Keyword(s):  
Paranasal Sinuses ◽  
Nasal Septum ◽  
Complex Disease ◽  
Anatomical Variation ◽  
Middle Turbinate ◽  
Inferior Turbinate ◽  
Anatomical Variations ◽  
Lateral Nasal Wall ◽  
Deviated Nasal Septum ◽  
Osteomeatal Complex

Background:The presence of septal deviation has been positively associated with sinus disease, especially osteomeatal complex disease and anterior and posterior ethmoid disease.Computerized tomographic imaging (CT) of the paranasal sinuses has become a widely accepted tool for assessing the paranasal sinuses (PNS) and providing a detailed anatomy of the lateral nasal wall.Objective:The objective of the study was to identify the anatomical variations of lateral nasal wall and paranasal sinuses in patients with Deviated nasal septum.Methods:Computerized tomographic (CT) examination was carried out using the bone algorithm in the coronal plane in 40 patients who met the inclusion criteriain the Postgraduate Department of Otorhinolaryngology and Head and Neck Surgery, SMHS Hospital an associated Hospital of Government Medical College, Srinagar from March 2011 to May 2012.Results:In our study, CT Nose and PNS revealed Deviated nasal septum in 40 (100%) patients, Hypertrophied Inferior turbinate in 11 (27.50%) patients, Concha bullosa in 5 (12.50%) patients, Paradoxical Middle turbinate in 8 (20%) patients, Everted Hypertrophied Uncinate in 2 (5%) patients, Aggernasi cells in 4 (10%) patients, Haller cells in 3 (7.50%) patients and Onodi cells in 2 (5%) patients.Conclusion:The most common anatomical variation associated with deviated nasal septum was Hypertrophied Inferior turbinate and the least encountered variation was Everted Hypertrophied Uncinate and Onodi cells. The CT scan provides supplementary clinical data to the history and endoscopic examination and assists in directing surgical treatment to the affected areas.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 90-93

scholarly journals CT evaluation of anatomical variations of paranasal sinus region and their clinical importance

2019 ◽  
Vol 7 (6) ◽  
pp. 2260
Author(s):  
Tapendra Nath Tiwari ◽  
Narendra Kumar Kardam
Keyword(s):  
Paranasal Sinus ◽  
Paranasal Sinuses ◽  
Anatomical Variation ◽  
Intraoperative Complications ◽  
Preoperative Evaluation ◽  
Anatomical Variations ◽  
Uncinate Process ◽  
Concha Bullosa ◽  
Increased Risk ◽  
Mucosal Changes

Background: Paranasal sinuses are air filled spaces present within the skull and facial bones. Paranasal sinuses region anatomy is highly variable. Knowledge of these variations is very important for radiologists as well as endoscopic surgeons for preoperative evaluation to avoid damage to adjacent vital structures. CT is the best modality to delineate the sinus anatomy as well as soft tissue structures. Thus, this study was undertaken to evaluate the anatomical variations of paranasal sinus region and ascertain their clinical importance.Methods: A total of 142 patients, those referred from various outdoor/indoor departments with the symptoms related to nose and paranasal sinuses were included. Detailed history, appropriate clinical examinations, biochemical investigations and X-ray PNS were recorded. Unenhanced CT scan of the PNS was performed for these patients in the axial planes and reformatted coronal planes. Observation was made and analysed using descriptive tools and scientific methods.Results: Deviated nasal septum was the most common variation followed by middle concha bullosa, Paradoxical middle turbinate, curved uncinate process, overpneumatized ethmoidal bulla, superior concha bullosa, prominent Agger Nasi cells, haller cells, onodi cells, maxillary sinus septae and pneumatization of uncinate process. Incidence of anatomical variation was 75% among the patients showing PNS mucosal changes while it was 94% among patients showing no mucosal changes. Chi square statics revealed that presence of anatomical variation does not mean a predisposition to mucosal changes.Conclusions: The presence of anatomical variants does not indicate predisposition to sinus pathology but may predispose to increased risk of intraoperative complications. It is important to pay close attention to anatomical variations in the preoperative evaluation to avoid possible complications.

scholarly journals Concha Bullosa in Paradoxical Middle Turbinate: A New Variation

2016 ◽  
Vol 9 (3) ◽  
pp. 141-142 ◽  
Author(s):  
Mohammad W El-Anwar ◽  
Ahmed I Ali
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Laboratory Tests ◽  
Anatomic Variation ◽  
Middle Turbinate ◽  
Anatomic Variations ◽  
Concha Bullosa ◽  
Normal Limits ◽  
Osteomeatal Complex ◽  
The Right

ABSTRACT Introduction Concha bullosa is the most common anatomic variation of osteomeatal complex region that is generally seen in the middle turbinate (MT). Materials and methods A 25-year-old male presented with headache and nasal obstruction. Computed tomography (CT) scan documented right paradoxical MT. The right MT also showed aerated concha bullosa with narrow right osteomeatal area. Routine preoperative laboratory tests were within normal limits. Results This case of concha bullosa in paradoxically bent MT was reported, described, and could be safely managed endoscopically. Patient was symptom free up to date without any complication, recurrence, or other pathology. Conclusion Computed tomography may easily identify such uncommon anatomic variations of the osteomeatal region. This directs the surgeon attention to these variations as a cause of headache and osteomeatal area obstruction. How to cite this article El-Anwar MW, Ali AI. Concha Bullosa in Paradoxical Middle Turbinate: A New Variation. Clin Rhinol An Int J 2016;9(3):141-142.

scholarly journals Influence of anatomic variations of the middle nasal meathus on sinonasal diseases

2008 ◽  
Vol 61 (3-4) ◽  
pp. 135-141 ◽  
Author(s):  
Maja Buljcik-Cupic ◽  
Slobodan Savovic ◽  
Jasna Jovicevic
Keyword(s):  
Data Processing ◽  
Chronic Rhinosinusitis ◽  
Correlation Coefficient ◽  
Nasal Septum ◽  
Anatomic Variation ◽  
Middle Turbinate ◽  
Lateral Nasal Wall ◽  
Anatomic Variations ◽  
Duration Of Symptoms ◽  
Middle Nasal Meatus

Introduction The most common anatomic variations of the structures of the middle nasal meatus are variations of agger nasi cells, variations of the middle turbinate, variations of uncinate process, variations of the ethmoidal bulla, deviations and deformations of nasal septum in the region of the middle nasal meatus, Haller's cell (orbitoethmoidal) and Onodi's cell(sphenoethmoidal cell). In 1997, the Otorhinolaryngology-Head Neck Surgery, Tasc Force on Chronic Rhinosinusitis defined chronic sinusitis and nasal disease initially by including sinusitis and rhinitis with one term-chronic rhinosinusitis. This was done because it was apparent to many that nasal disoders often affected the sinuses, and vice versa. Also they established baseline parameters, major and minor signs and symptoms, for definition of rhinosinusitis. Two major factors or one major factor and two minor factors constitute a strong history for rhinosinusitis. Material and methods The following methods were used in the study: 1. Anamnestic data processing about: disease symptoms that were recognired by American Academy for ENT as major and minor criteria in diagnosing nosinusitis; the duration of symptoms; the kind of sinonasal disorder and the secondary disorders. 2. Data processing obtained by anterior/posterior rhinoscopy. 3. Data processing obtained by endoscopic examination. 4. Data processing obtained by CT of paranasal cavities and the nose. The data about anatomic variations were statistically processed by Eives's correlation coefficient that indicates the degree of correlation between sinonasal disorders and anatomic variation. Results By analyzing the obtained data in the examined patients with sinonasal disorders, anatomic variations were present in over 50% of the patients and are defined by percentage. I. The deviation of nasal septum in 83.33% patients. 2. The variations of the form of the middle nasal chonha in 58.92% patients. 3. The presence of agger nasi cells in 50% patients. 4. Variations of the form of ethomoidal bulla in 50% patients. Eives's correlation coefficient i.e. the degree of correlation between sinonasal disorders and the presence of anatomic variation statistically significantly correlate at r >/= ft 05 of anatomic variation of the middle nasal chonha (r =0.23) and the presence of deviation/deformation of nasal septum (r = 0.6) with sinonasal disorders. Discussion and conclusion Anatomic variations of the structures of the middle nasal meatus can additionally complicate the anatomy of the lateral nasal wall and the conditions of the ostiomeatal unit. Therefore we must view these variations as factors predisposing to more rapid and frequent appearance and persistence of chronic inflammations. Also, familiary with the variations in sinonasal anatomy is a prerequisite to safe and effective surgical treatment of sinonasal disease. Recognition of this anatomic variation should minimize catastrophic violation of vital structures such as orbit or skull base.

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