Abstract
A 42-year-old woman presented with a left nasal airway obstruction. Endoscopic examination of her nose showed an extremely hypertrophic left inferior turbinate (figure, A). The right inferior turbinate was of normal size. She elected to undergo nasal airway reconstruction with partial inferior turbinate reduction of the left inferior turbinate.
At the time of surgery, a large inferior turbinate was encountered in the left nasal airway. The anteroinferior portion of the left inferior turbinate was entered with a 2-mm microdebrider turbinate blade (figure, B). The dissection was remarkable because after entering the turbinate through the small puncture incision (figure, C), we encountered a large cavity. The opening was enlarged, revealing a well-pneumatized inferior turbinate (figure, D). The inferior portion of the inferior turbinate was removed with a microdebrider, reducing its bulk and improving the left nasal airway.
Pneumatization of the nasal turbinates is a common anatomic variant that most frequently occurs as a concha bullosa of the middle turbinate. 1 Pneumatization of the superior turbinate was reported by Van Alyea as also occurring in approximately 57% of cases. 2 Very rarely has pneumatization of the inferior turbinate been described in the literature.1,3,4
Pneumatization of the inferior turbinate, or concha bullosa of the inferior turbinate, is clinically significant when it causes persistent nasal airway obstruction. However, this is a rare and unusual cause of nasal obstruction.