open access

Vol 78, No 1 (2019)
CASE REPORTS
Published online: 2018-05-17
Submitted: 2018-03-05
Accepted: 2018-05-08
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Bifid and secondary superior nasal turbinates

M. C. Rusu, M. Săndulescu, C. J. Sava, D. Dincă
DOI: 10.5603/FM.a2018.0047
·
Pubmed: 29802719
·
Folia Morphol 2019;78(1):199-203.

open access

Vol 78, No 1 (2019)
CASE REPORTS
Published online: 2018-05-17
Submitted: 2018-03-05
Accepted: 2018-05-08

Abstract

The lateral nasal wall contains the nasal turbinates (conchae) which are used as landmarks during functional endoscopic surgery. Various morphological pos- sibilities of turbinates were reported, such as bifidity of the inferior turbinate and extra middle turbinates, such as the secondary middle turbinate. During a retrospective cone beam computed tomography study of nasal turbinates in a patient we found previously unreported variants of the superior nasal turbina- tes. These had, bilaterally, ethmoidal and sphenoidal insertions. On the right side we found a bifid superior turbinate and on the left side we found a secondary superior turbinate located beneath the normal/principal one, in the superior nasal meatus. These demonstrate that if a variant morphology is possible for a certain turbinate, it could occur in any nasal turbinate but it has not been yet observed or reported. 

Abstract

The lateral nasal wall contains the nasal turbinates (conchae) which are used as landmarks during functional endoscopic surgery. Various morphological pos- sibilities of turbinates were reported, such as bifidity of the inferior turbinate and extra middle turbinates, such as the secondary middle turbinate. During a retrospective cone beam computed tomography study of nasal turbinates in a patient we found previously unreported variants of the superior nasal turbina- tes. These had, bilaterally, ethmoidal and sphenoidal insertions. On the right side we found a bifid superior turbinate and on the left side we found a secondary superior turbinate located beneath the normal/principal one, in the superior nasal meatus. These demonstrate that if a variant morphology is possible for a certain turbinate, it could occur in any nasal turbinate but it has not been yet observed or reported. 

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Keywords

nasal fossa; nasal concha; bifid turbinate; secondary turbinate; sphenoethmoidal recess

About this article
Title

Bifid and secondary superior nasal turbinates

Journal

Folia Morphologica

Issue

Vol 78, No 1 (2019)

Pages

199-203

Published online

2018-05-17

DOI

10.5603/FM.a2018.0047

Pubmed

29802719

Bibliographic record

Folia Morphol 2019;78(1):199-203.

Keywords

nasal fossa
nasal concha
bifid turbinate
secondary turbinate
sphenoethmoidal recess

Authors

M. C. Rusu
M. Săndulescu
C. J. Sava
D. Dincă

References (28)
  1. Aksungur EH, Biçakçi K, Inal M, et al. CT demonstration of accessory nasal turbinates: secondary middle turbinate and bifid inferior turbinate. Eur J Radiol. 1999; 31(3): 174–176.
  2. Al-Qudah MA. Extra middle turbinate lamellas: a suggested new classification. Surg Radiol Anat. 2015; 37(8): 941–945.
  3. Ariyürek OM, Balkanci F, Aydingöz U, et al. Pneumatised superior turbinate: a common anatomic variation? Surg Radiol Anat. 1996; 18(2): 137–139.
  4. Aykut M, Gümüsburun E, Müderrïs S, et al. The secondary nasal middle concha. Surg Radiol Anat. 1994; 16(3): 307–309.
  5. Chastain JB, Sindwani R. Anatomy of the orbit, lacrimal apparatus, and lateral nasal wall. Otolaryngol Clin North Am. 2006; 39(5): 855–864, v.
  6. Clerico DM. Pneumatized superior turbinate as a cause of referred migraine headache. Laryngoscope. 1996; 106(7): 874–879.
  7. Cobzeanu MD, Bâldea V, Bâldea MC, et al. The anatomo-radiological study of unusual extrasinusal pneumatizations: superior and supreme turbinate, crista galli process, uncinate process. Rom J Morphol Embryol. 2014; 55(3 Suppl): 1099–1104.
  8. Fidan V. Panconcha bullosa: new definition in the literature. J Craniofac Surg. 2012; 23(3): e253–e254.
  9. Gotlib T, Kuźmińska M, Sokołowski J, et al. The supreme turbinate and the drainage of the posterior ethmoids: a computed tomographic study. Folia Morphol. 2018; 77(1): 110–115.
  10. Kantarci M, Karasen RM, Alper F, et al. Remarkable anatomic variations in paranasal sinus region and their clinical importance. Eur J Radiol. 2004; 50(3): 296–302.
  11. Kiroglu AF, Cankaya H, Yuca K, et al. Isolated turbinitis and pneumatization of the concha inferior in a child. Am J Otolaryngol. 2007; 28(1): 67–68.
  12. Koo SK, Kim JD, Moon JiS, et al. The incidence of concha bullosa, unusual anatomic variation and its relationship to nasal septal deviation: A retrospective radiologic study. Auris Nasus Larynx. 2017; 44(5): 561–570.
  13. Lee JH, Koh SH. A variant form of bifid inferior turbinate. Ear Nose Throat J. 2011; 90(9): E33–E34.
  14. Lee SY, Bae KE, Lee HB, et al. Bilateral accessory inferior turbinates and secondary middle turbinates. Jpn J Radiol. 2012; 30(6): 530–532.
  15. Măru N, Rusu MC, Săndulescu M. Variant anatomy of nasal turbinates: supreme, superior and middle conchae bullosae, paradoxical superior and inferior turbinates, and middle accessory turbinate. Rom J Morphol Embryol. 2015; 56(3): 1223–1226.
  16. Orlandi RR, Lanza DC, Bolger WE, et al. The forgotten turbinate: the role of the superior turbinate in endoscopic sinus surgery. Am J Rhinol. 1999; 13(4): 251–259.
  17. Ozcan KM, Selcuk A, Ozcan I, et al. Anatomical variations of nasal turbinates. J Craniofac Surg. 2008; 19(6): 1678–1682.
  18. Rusu MC, Măru N, Săndulescu M, et al. Rare anatomic variation: true bifid inferior turbinate. Surg Radiol Anat. 2018; 40(2): 217–220.
  19. Rusu MC, Săndulescu M, Bichir C, et al. Combined anatomical variations: The mylohyoid bridge, retromolar canal and accessory palatine canals branched from the canalis sinuosus. Ann Anat. 2017; 214: 75–79.
  20. Sava CJ, Rusu MC, Săndulescu M, et al. Vertical and sagittal combinations of concha bullosa media and paradoxical middle turbinate. Surg Radiol Anat. 2018; 40(7): 847–853.
  21. Say P, Leopold D, Cochran G, et al. Resection of the inferior superior turbinate: does it affect olfactory ability or contain olfactory neuronal tissue? Am J Rhinol. 2004; 18(3): 157–160.
  22. Selcuk A, Ozcan KM, Ozcan I, et al. Bifid inferior turbinate: a case report. J Laryngol Otol. 2008; 122(6): 647–649.
  23. Spear SA, Brietzke SE, Winslow C. Bilateral bifid inferior turbinates. Ann Otol Rhinol Laryngol. 2003; 112(2): 195–196.
  24. Stammberger H. Functional endoscopic sinus surgery. BC Decker: Mosby, Philadelphia 1991.
  25. Toplu Y, Bayindir T, Karatas E, et al. All concha bullosa: an undefined abnormality of the lateral nasal wall. Indian J Otolaryngol Head Neck Surg. 2013; 65(1): 86–88.
  26. Tubbs RS, Loukas M, Shoja MM. Bergman's comprehensive encyclopedia of human anatomic variation. John Wiley & Sons, 2016 .
  27. Wang RG, Jiang SC. The embryonic development of the human ethmoid labyrinth from 8-40 weeks. Acta Otolaryngol. 1997; 117(1): 118–122.
  28. Yılmaz MS, Güven M, Akidil Ö, et al. Bifid inferior turbinate: a report of two cases. Kulak Burun Bogaz Ihtis Derg. 2014; 24(6): 357–360.

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