Giant Concha Bullosa Containing Ethmoid Bulla Inside: A Case Report

Area of Science:

• Otolaryngology
• Medical Imaging
• Surgical Anatomy

Background:

• Paranasal sinus anatomy presents frequent variations crucial for successful endoscopic sinus surgery.
• Concha bullosa, an air cell in nasal turbinates, commonly occurs in the middle turbinate (13-53.6%).
• Ethmoid bulla, an anterior ethmoid sinus air cell, is anatomically near the middle turbinate.

Purpose of the Study:

• To report a rare case of a giant concha bullosa containing an ethmoid bulla.
• To emphasize the significance of identifying uncommon anatomical variations in paranasal sinuses.
• To underscore the role of advanced imaging in preoperative planning for sinus surgery.

Main Methods:

• A 52-year-old female patient presented with symptoms of nasal obstruction and snoring.
• Computed tomography (CT) scanning was utilized to diagnose the anatomical variation.
• The patient underwent successful endoscopic sinus surgery for the removal of the concha bullosa and ethmoid bulla.

Main Results:

• A giant concha bullosa within the left middle turbinate, containing an ethmoid bulla, was identified.
• The patient experienced complete symptom resolution following the surgical intervention.
• The case represents a unique anatomical variation not covered by existing concha bullosa classifications.

Conclusions:

• This case highlights an exceptionally rare anatomical variation of the paranasal sinuses.
• Preoperative identification of both common and rare sinus variations is vital for safe and effective endoscopic sinus surgery.
• Modern imaging techniques significantly improve the preoperative assessment of complex sinonasal anatomy.