Is pneumatization of middle turbinates compensatory or congenital?

Giant concha bullosa presented as left nasal mass: a case report and literature review

Concha bullosa (CB) is not considered to be a disease, but rather a variation of the paranasal sinus. A CB is defined as the presence of an air cell within the turbinate (pneumatization). The main function of CB is to maintain upper respiratory humidity, regulate thermoregulation, and regulate airflow and filtration. It is common for CB to occur in the middle turbinate, while superior and inferior locations appear to be rare. The patient in this case report was presented mainly with nasal obstruction. During examination, a large mass was found in the left nasal cavity, causing a deviated nasal septum to the right. For this patient, surgery was the last resort. Either perioperative or postoperative complications were observed, and the quality of life of patients improved after surgery.

New case of concha bullosa from Bronze Age Iberia (Granada, Spain)

OBJECTIVE

This study aims to expand knowledge of Concha bullosa in a prehistoric population.

MATERIALS

The skull of an adult female from the Bronze Age archeological site ofCastellón Alto (Granada, Spain), dated between 1900 and 1600 BCE.

METHODS

The diagnosis of middle turbinateconcha bullosa was based on macroscopic, radiographic, and computed tomography studies.

RESULTS

This is one of the oldest findings ofconcha bullosa in Europe. Despite the possible obstruction of the osteomeatal complex by the concha bullosa in this individual, no signs of sinusitis were observed in maxillary sinuses.

CONCLUSIONS

The maxillary sinuses of this female showed no signs of sinusitis related to theconcha bullosa.

SIGNIFICANCE

This study provides new evidence on the chronological limits of this condition. The particular funeral rites of these populations have preserved the majority of skeletons at this site in an excellent condition.

LIMITATIONS

The identification ofconcha bullosa continues to be rare in ancient populations, in part due to the poor preservation of nasal bones in archeological collections. Suggestions for further research: Detailed study of the nasal cavity of adequately preserved individuals can be expected to identify further cases of concha bullosa in ancient populations.

The association of superior attachment of uncinate process with pneumatization of middle turbinate: a computed tomographic analysis

The frontal sinus outflow pathway is complex and can be influenced by the configuration of the uncinate process (UP). The UP can attach superior to the lamina papyracea, skull base, and middle turbinate. The factors associated with superior attachment remain unclear. This study analyzed the relationships between different types of superior UP attachment and characteristics of the surrounding structures including the agger nasi cell, skull base, and middle turbinate. This retrospective study utilized computed tomography images of 836 sides with identifiable sinus structure from 434 Taiwanese patients. Types of superior UP attachment, height of the ethmoid cribriform plate, prevalence of agger nasi cell, and degree of pneumatization of the middle turbinate were analyzed. In the current study, neither the presence of an agger nasi cell nor height of the cribriform plate had significant relationship with superior UP attachment type. However, UP attachment type was statistically significantly associated with pneumatized middle turbinate (PMT) type (p < 0.01). The PMT group had a higher incidence of UP attachment to the middle turbinate (38%) than the non-PMT group (18%). In the extensive PMT group, the incidence of UP attachment to the middle turbinate was high to 49%. In conclusion, superior UP attachment to the middle turbinate was associated with pneumatization of the middle turbinate. The UP has a greater tendency to attach to the middle turbinate in cases with more PMT.

An often neglected area in crooked nose: middle turbinate pneumatization

Introduction

Crooked or deviated nose is a deviation of the nose from the straight vertical position of the face. Extensive pneumatization of the middle turbinate, also called concha bullosa or bullous middle turbinate (BMT) is known to be one of the possible etiologic factors in nasal obstruction, recurrent sinusitis, and headache. There is no study concerning a link between BMT and crooked nose.

Objective

To investigate the association between crooked nose and the presence of a BMT.

Methods

A total of 199 patients who underwent open septorhinoplasty were retrospectively analyzed. Preoperative paranasal Computerized Tomography (CT) findings, preoperative photodocumentation, and anterior rhinoscopic examination findings were documented. Of the 199 patients, 169 were found to meet the criteria and were included in the study. CT scans were examined to note the presence of BMT, inferior turbinate hypertrophy, and septum deviation (SD). SDs and crooked noses were classified.

Results

Ninety-four of 169 patients (56%) presented a crooked nose deformity and seventy-five of 169 patients (44%) presented a straight nose. While 49 (52%) crooked nose patients had a bulbous and extensive BMT, 20 patients with straight nose (26.6%) had a BMT. A statistically significant relationship was found between the presence of crooked nose and BMT, regardless of the side of the disease (p = 0.011).

Conclusion

This study revealed a link between crooked nose and BMT.

'Conchae bullosis': a rare case with bilateral triple turbinate pneumatisations

BACKGROUND

Concha bullosa is the pneumatisation of intranasal conchae (usually the middle turbinate, and rarely the inferior or superior turbinate); however, the term is generally used to describe aeration of the middle concha. Superior concha bullosa is a rare finding, and only a few cases of inferior concha bullosa have been reported in the medical literature. When symptomatic, concha bullosa may cause various problems including nasal congestion, headache, postnasal drip, anosmia and, sometimes, epiphora.

METHODOLOGY

Computed tomography, following history-taking and physical examination, is a valuable tool in diagnosing turbinate pneumatisation. This article presents a very rare case with bilateral triple conchae pneumatisations.

RESULTS

The symptomatology, diagnosis and treatment options for cases of multiple concha bullosa are discussed. The surgical interventions performed in the presented case are briefly described.

CONCLUSION

The presented patient had pneumatisation of all six turbinates. In such cases, we propose that this condition be termed 'conchae bullosis' rather than 'conchae bullosa', in a similar fashion to the use of nasal polyposis as the plural form of nasal polyp.