Journal of Otology & RhinologyISSN: 2324-8785

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Case Report, J Otol Rhinol Vol: 6 Issue: 1

A Rare Case: Double Concha Bullosa

Fidan V*
Yunus Emre Goverment Hospital, Turkey
Corresponding author : Fidan V, MD
Associate Prof and Deputy Director of ENT Department, Yunus Emre Goverment Hospital, 26100, Eskisehir Turkey
Tel:
+90 505 560 6842
E-mail: [email protected]
Received: April 30, 2015 Accepted: December 05, 2016 Published: January 04, 2017
Citation: Fidan V (2017) A Rare Case: Double Concha Bullosa. J Otol Rhinol 6:1. doi: 10.4172/2324-8785.1000304

Abstract

Aeration of nasal turbinates are named as concha bullosa. Concha bullosa is an often seen diversity of turbinates.but concha bullosa in another concha bullosa is never reported. Here is a thirty year old woman whish was presented of concha bullosa in a concha bullosa.

Keywords: Nasal pathology; Concha bullosa; Rhinorrhoea; Turbinate

Keywords

Nasal pathology; Concha bullosa; Rhinorrhoea; Turbinate

Introduction

The turbinates are important structures originated from the lateral wall of the nose . Concha Bullosa is an air pocket in the turbinate [1]. Concha bullosa is a very common anatomical deviation of turbinates. Cyctic distension can be found in all turbinates [2,3]. But there are small number of reports about a case with concha bullosa in concha bullosa [4]. Here we describe a patient who has nasal obstruction due to concha bullosa in concha bullosa.

Case Report

A 30 year-old woman was admitted to our clinic with complaints of rhinorrhoea and nasal obstruction. She had suffered with these symptoms for several years. Nasal examination showed large middle turbinates and nasal discharge. She was treated with oxymetazoline hydrochloride 0.005%. But there was no improvement in her symptoms. A computed tomography (CT) scan of her paranasal sinuses was performed. CT of the paranasal sinuses showed concha bullosa in middle turbinates. But there is concha bullosa in concha bullosa in left side of her nose (Figures 1 and 2). In addition, discharge in nasal cavity was also observed. The patient underwent endoscopic sinus surgery under general anaesthetic. Intra-operative examination showed hypertrophy of middle turbinates. The middle concha bullosas were resected but there was another concha bullosa in left concha bullosa. The endoscopic examination that was done one month after the operation and her nasal obstruction had improved significantly.
Figure 1: Axial cross-section of the paranasal sinus computed tomography (Double concha bullosa in left middle turbinate) .
Figure 2: Coronal cross-section of the paranasal sinus computed tomography (Double concha bullosa in left middle turbinate).

Discussion

Concha bullosa is a cystic inflation of the nasal turbinate and the most frequent alteration of the sinonasal region [1,2]. It is commonly concured in the middle concha. It is seldom found in the superior and inferior conchae. Presence of bilateral conchae bullosa alines between 45%-61.5% [3,5]. But there was only one case with air cells in all turbinates [6]. Also anatomical variation of concha bullosa in concha bullosa is extremely rare. Comparative studies including asymptomatic patients and sinusitis patients have informed that concha bullosa is more often encountered in patients with sinusitis [3-5]. There are articles show that the size of concha bullosa is consequential for sinusitis’s signs and headache [2]. Conclusion In patients with sinusitis and nasal obstruction, concha bullosa in concha bullosa (double concha bullosa) must be kept in the mind.

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