[The middle turbinate as the cause of sinusal pathology]

The middle turbinate and its anatomical variations (concha bullosa and paradoxically bent middle turbinate) may be the site of different pathologies due to the alteration of the sinus function at the key area of the osteomeatal complex. In the present work we study 4 cases of concha bullosa and 4 cases of paradoxically bent middle turbinates, associated to recurrent sinusitis and/or headaches, which underwent endoscopic surgery. Improvement was achieved in all recurrent circumscribed sinusitis. One of the patients with bilateral paradoxically bent middle turbinate had an associated pansinusitis, and he only improved in his right side. An aspergilloma was found inside one of the conchae bullosae. Headaches improved in all the cases analyzed. Anatomic variations may be the cause of recurrent sinusal pathology or isolated headaches and it should be noted that, in correctly selected groups, a dramatic improvement can be achieved with a minor surgical procedure on the middle turbinate or ethmoidal infundibulum.