Clinical Case of the Combination of Concha Bullosa and Middle Tunale Hypertrophy

Bullous middle turbinate (concha bullosa) is one of astructural variants, characterized by varying degrees of pneumatization of the middle turbinate and an incidence rate from 14% to 53%. Clinical description: a 42-year-old woman was admitted with complaints of nasal congestion, nasal breathing difficulties, and recurrent rhinosinusitis. Anterior rhinoscopy revealed a large bulla of the middle turbinate on the right, pushing the nasal septum to the left. Computed tomography of the sinuses in the right half of the nose showed that the bulla of the middle turbinate was 22x25x15 mm (Figure 2), the posterior part of the middle turbinate was hypertrophic, exceeding the size of the inferior turbinate and pushing the nasal septum to the leftEndoscopic resection of the lateral wall of the concha bullosa, partial resection of the horizontal plate of the middle turbinate, followed by lateralisation and partial resection of the posterior end of the right middle turbinate were performed under general anaesthesia. At the follow-up examination 3 months later, the patient had no complaints; during the endoscopic examination, the nasal septum was in the midline, the area of the right middle nasal meatus was wide, epithelialized, the anastomosis of the maxillary sinuses was patent. Conclusions: this clinical case is particularly interesting because of the rare combination of a large bulla of the middle turbinate and hypertrophy of the posterior part of the middle turbinate with displacement of the structures of the nasal cavity in the opposite direction.