A RARE CAUSE OF NASAL OBSTRUCTION AND HEADACHE: A GIANT BULLAE ETHMOIDALIS INSIDE THE CONCHA BULLOSA

Öz

The existence of a giant ethmoidal bullae and its invading into the concha bullosa is a rare situation. Two cases reported in literature up to date, this case will be the third. Herein we report a case admitted due to the complaints of headache, facial pain and nasal obstruction. A giant ethmoidal bullae inside the concha bullosa was detected in preoperative CT scans. Surgical treatment approaches and literature review will be presented. It is important to discover anatomical variations preoperatively in paranasal sinus surgery to avoid complications.

Anahtar Kelimeler

• bullae ethmoidalis
• giant
• concha

Nazal obstrüksiyon ve başağrısının nadir bir nedeni; Konka büllozanın içine doğru uzanım gösteren büyük bir bulla etmoidalis

Öz

Dev etmoid bulla ve bunun konka büllozanın içine doğru uzanım göstermesi nadir görülen bir durumdur. Literatürde iki vaka bildirilmiş olup bu üçünçü vakadır. Olgumuzda hasta başağrısı, yüz ağrısı ve nazal obstrüksiyon şikayetleri ile başvurdu. Preoperatif paranazal BT de büyük bir etmoid bullanın konka bülloza içine doğru uzanım yaptığı görülmektedir. Olgu cerrahi olarak tedavi edilmiş olup literatür eşliğinde değerlendirildi. Paranazal sinüs cerrahisinde komplikasyonlardan kaçınmak için preoperatif anatomik varyasyonların değerlendirilmesi önemlidir

Anahtar Kelimeler

• Bulla etmoidalis
• büyük
• konka bülloza

Kaynakça

1. Lee HY, Kim CH, Kim JY, et al. Surgical anatomy of the middle turbinate. Clin Anat
2. ;19:493-6.
3. Braun H, Stammberger H. Pneumatization of turbinates. Laryngoscope 2003;113:668-72.
4. Lin YL, Lin YS, Su WF, et al. A secondary middle turbinate co-existing with an accessory
5. middle turbinate: an unusual combination of two anatomic variations. Acta Otolaryngol
6. ;126:429-31.
7. Eren SB, Kocak I, Dogan R, et al. A comparison of the long-term results of crushing and
8. crushing with intrinsic stripping techniques in conchabullosa surgery. Int Forum Allergy

9. Rhinol. 2014;4(9):753-8.
10. Ozturan O, Degirmenci N. Pneumo-concha dilatans: middle concha growing in anterior
11. and lateral directions. J Craniofac Surg. 2013;24(4):444-6.
12. Zuckerkandl E. Die untere Siebbeinmuschel {mitther Nasanmuschel). norniale und
13. patbologische Anatomie der Nasenhohle und ihrer pneumatischen Anhange. Vols I and 2.
14. Vienna. 1893.
15. Neskey D, Eloy JA, Casiano RR. Nasal, septal, and turbinate anatomy and embryology.
16. Otolaryngol Clin North Am. 2009;42(2):193-205
17. Scribano E, Ascenti G, Loria G, Cascio F, Gaeta M: The role of the ostiomeatal unit
18. anatomic variations in inflammatory disease of the maxillary sinuses. Eur J Radiol 1997,
19. :172-174.
20. Setliff RC, Catalano PJ, Catalano LA, Francis C: An anatomic classification of the
21. ethmoidal bulla. Otolaryngol Head Neck Surg 2001, 125:598-602
22. Cukurova I,Yaz A, Gumussoy M. A patient presenting with concha bullosa in another
23. concha bullosa: a case report. Journal of Medical Case Reports 2012, 6:87
24. Ceylan S, Bora F, Batmaz T. Complex Concha Bullosa. Otolaryngol 2012, 2:1
25. Ozgursoy OB, Kucuk B. Giant concha bullosa containing another concha bullosa inside:
26. unique anatomic variation of the middle turbinate. Rhinology 2007;45:248-50.
27. Peric A, Baletic N. A case of an uncommon anatomic variation of the middle turbinate
28. associated with headache. ACTA otorhinolaryngologica ita lica 2010;30:156-159
29. Shihada R, Luntz M. A concha bullosa mucopyocele manifesting as migraine headaches:
30. a case report and literature review. Ear Nose Throat J. 2012;91(5):16-8.
31. Huang HH, Lee TJ, Huang CC, et al. Non-sinusitis related rhinogenous headache: a tenyear
32. experience. Am J Otolaryngol 2008;29:326-32