Anomalous middle turbinate with choanal obstruction and maxillary sinusitis: a case report

Journal of Medical Case Reports

Kyu-Sup Cho²  Sung-Lyong Hong²  Jung-Hoon Lee²  Yong-Wan Kim¹ 

[1] Department of Otorhinolaryngology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea;Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, 1-10 Ami-dong, Seo-gu, Busan 602-739, Republic of Korea

关键词: Turbinates;    Nasopharynx;    Nasal obstruction;    Maxillary sinusitis;    Congenital abnormalities;   

Others  :  825208
DOI  :  10.1186/1752-1947-7-242

 received in 2013-04-29, accepted in 2013-09-05,  发布年份 2013

【 摘 要 】

Introduction

Although several anatomical anomalies in the middle turbinate have been reported, they usually remain asymptomatic. However, complicated aberrant middle turbinate extending through the choana to the contralateral nasopharynx has not been reported.

Case presentation

A 23-year-old Korean woman presented with a 6-month history of nasal obstruction and postnasal discharge refractory to medical treatment. An endoscopic examination revealed an abnormal middle turbinate, and a pedunculated nasal mass covered with normal mucosa that originated from the right lateral nasal wall filled most of the right posterior choana and extended to the left nasopharynx across the posterior free edge of the nasal septum. Computed tomography of the paranasal sinus showed abnormal bony trabeculation from the posterior bony attachment of the right middle turbinate to the left posterior nasopharyngeal wall. In addition, right maxillary sinusitis was observed. From these findings, the lesion was suspected to be an abnormal configuration of the right middle turbinate with secondary maxillary sinusitis and was successfully treated by resection of the malformed middle turbinate and middle meatal antrostomy.

Conclusions

Although this case illustrates a very rare developmental anomaly of the middle turbinate, thorough knowledge of the development of and anatomical anomalies associated with the middle turbinate is of utmost importance to perform proper sinus surgery and avoid complications. Therefore, these findings should be considered by otolaryngologists, and careful examination of the nasal cavity is necessary to determine the existence of this rare anomaly.

【 授权许可】

   
2013 Kim et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Ozcan KM, Selcuk A, Ozcan I, Akdogan O, Dere H: Anatomical variations of nasal turbinates. J Craniofac Surg 2008, 19:1678-1682.
• [2]El-Shazly AE, Poirrier AL, Cabay J, Lefebvre PP: Anatomical variations of the lateral nasal wall: The secondary and accessory middle turbinates. Clin Anat 2012, 25:340-346.
• [3]Aydil U, Ozçelik T: Unilateral agenesis of middle nasal turbinate. J Laryngol Otol 2010, 124:447-449.
• [4]Neskey D, Eloy JA, Casiano RR: Nasal, septal, and turbinate anatomy and embryology. Otolaryngol Clin North Am 2009, 42:193-205.
• [5]Stammberger HR, Kennedy DW, Anatomic Terminology Group: Paranasal sinuses: anatomic terminology and nomenclature. Ann Otol Rhinol Laryngol Suppl 1995, 167:7-16.
• [6]Pernas FG, Coughlin AM, Hughes SE, Riascos R, Maeso PA: A novel use of a landmark to avoid injury of the anterior ethmoidal artery during endoscopic sinus surgery. Am J Rhinol Allergy 2011, 25:54-57.