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Endoscopic view of a septated concha bullosa.



[FIGURE A-F OMITTED]

A 43-year-old man was referred to us for evaluation of recurring ethmoid ethmoid /eth·moid/ (eth´moid)
1. sievelike; cribriform.

2. the ethmoid bone; see Table of Bones. .ethmoi´dal


eth·moid or eth·moi·dal
adj.
 sinusitis. Computed tomography (CT) of the sinuses identified an uncommon septated concha bullosa of the right middle turbinate turbinate /tur·bi·nate/ (-nat)
1. shaped like a top.

2. any of the nasal conchae.


tur·bi·nate or tur·bi·nat·ed
adj.
1. Shaped like a top.

2.
 and a hypoplastic Hypoplastic
Incomplete or underdevelopment of a tissue or organ. Hypoplastic left heart syndrome is the most serious type of congenital heart disease.

Mentioned in: Congenital Heart Disease

hypoplastic,
adj
 septated right antrum (figure, A). Clinical examination revealed a prominent right middle turbinate (figure, B).

The patient elected to undergo functional endoscopic sinus surgery functional endoscopic sinus surgery Functional endonasal endoscopic sinus surgery ENT A procedure that removes diseased nasal cavity and paranasal sinus tissue and restores mucociliary clearance Applications Chronic and/or recurrent sinusitis in Pts who fail . The concha bullosa was entered anteriorly, revealing an anterior compartment (figure, C) that extended inferiorly below a posterior and superior compartment (figure, D). The lateral portions of both concha concha /con·cha/ (kong´kah) pl. con´chae   [L.] a shell-shaped structure.

concha of auricle
 compartments were removed, revealing a well-defined ostium ostium /os·ti·um/ (os´te-um) pl. os´tia   [L.] an opening or orifice.os´tial

ostium abdomina´le tu´bae uteri´nae
 of the posterior and superior compartment (figure, E). At the termination of the procedure, the lateral and inferior portion of the right concha bullosa was resected, which allowed for adequate drainage and ventilation (figure, F).

A concha bullosa of the middle turbinate is a relatively common anatomic variant that may be associated with enlargement of the turbinate. Chronic rhinosinusitis may occur in association with a concha bullosa when the middle meatus is subsequently narrowed. (1) Powered instrumentation has been used successfully as a tool for opening and partially removing a concha bullosa, thereby reducing the width of the middle turbinate and allowing for access to the middle meatus if needed. (2) Because its development is related to the ethmoid sinus, a concha bullosa can exhibit various patterns of drainage into the middle meatus of the nasal cavity. (3,4) This case illustrates an interesting anatomic variation of a septated concha bullosa.

References

(1.) Stammberger HR. Functional Endoscopic Sinus Surgery: The Messerklinger Technique. Philadelphia: B.C. Decker; 1991.

(2.) Mirante JP, Christmas DA, Yanagisawa E. Powered endoscopic turbinate surgery. In: Yanagisawa E, Christmas DA, Mirante IP, eds. Powered Instrumentation in Otolaryngology-Head and Neck Surgery. San Diego: Singular-Thomson Learning; 2001:174-8.

(3.) Christmas DA, Mirante JP, Yanagisawa E. An unusual medial ostium of a concha bullosa of the middle turbinate. Ear Nose Throat J 2002;81(8):491-2.

(4.) Yanagisawa E, Mirante JP, Christmas DA. An unusual lateral ostium of a concha bullosa of the middle turbinate. Ear Nose Throat 12003;82(3):159-60.

Eiji Yanagisawa, MD, FACS FACS Fellow of the American College of Surgeons.

FACS
abbr.
Fellow of the American College of Surgeons



FACS

fluorescence-activated cell sorter.
; Joseph P. Mirante, MD, FACS; Dewey A. Christmas, MD

From the Southern New England Ear, Nose, Throat, and Facial Plastic Surgery Group; the Section of Otolaryngology, Hospital of St. Raphael; and the Section of Otolaryngology, Yale University School of Medicine, New Haven, Conn. (Dr. Yanagisawa); and the Department of Otolaryngology, University of South Florida College of Medicine As of Fall 2006, there were 477 students in the M.D. program; 78 students in the M.S. and 83 students in the Ph.D. program in the School of Basic Biomedical Sciences; and 55 students in the DPT program in the School of Physical Therapy. , Tampa, and the Halifax Medical Center Halifax Medical Center (HMC) is a 764-bed hospital located in Daytona Beach, Florida. HMC is the largest hospital serving Volusia and Flagler counties and provides the area's only trauma center, pediatric emergency department, neonatal intensive care unit and pediatric intensive , Daytona Beach, Fla. (Dr. Mirante and Dr. Christmas).
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Title Annotation:RHINOSCOPIC CLINIC
Author:Yanagisawa, Eiji; Mirante, Joseph P.; Christmas, Dewey A.
Publication:Ear, Nose and Throat Journal
Geographic Code:1USA
Date:Feb 1, 2008
Words:423
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