A unique case of multiple sites of pneumatization of the sinonasal bony framework in a pediatric patient

Concha Bullosa of the Inferior Turbinate

Inferior concha bullosa is a rare disease that has been related to sinonasal symptoms. This study aimed to determine the characteristics of concha bullosa in the inferior turbinate and assess its common clinical manifestations, computed tomography findings, and the surgical techniques used to treat the condition. We conducted a search of the PubMed database, using the Preferred Reporting Items of Systematic Reviews and Meta-Analysis, for articles published until May 2021 using the following terms: "inferior turbinate and concha bullosa"; "inferior turbinate and pneumatization"; and in combination with other terms such as "concha bullosa release and concha bullosa excision", among others. We found 12 papers that met our inclusion criteria. The main presenting symptom was a nasal obstruction in 13 patients (100%), followed by headache in 10 patients (77%). The site of inferior concha bullosa was bilateral in six cases and left-sided in five cases. Computed tomography was conducted in all cases in this review. The type of intervention performed was medical, surgical, and both in 23%, 54%, and 23% of the cases. Despite multimodal surgical approaches and medical treatment, all the outcomes were good and no compactions were noted. All cases also had good prognoses.

Conchae Bullosis in a Pediatric Patient

Pneumatization of the turbinates called concha bullosa is one of the most frequent anatomic variations of the nasal cavity. We report the first case of computed tomography findings of bilateral middle and inferior concha bullosa in a 13-year-old child with nasal obstruction. Here we describe a patient with extreme bilateral bullosa of inferior and middle conchas, as well as crista galli. The patient was treated successfully with endoscopic surgery of conchas. Nasal obstruction secondary to a bilateral turbinate bullosis in a child has not been described before. The clinicians should take this entity into consideration when evaluating the pediatric patients with nasal obstruction.

Bilateral aplasia of paranasal sinuses

Paranasal sinus anatomical anomalies with unknown etiology are common. Maxillary and/or frontal sinus aplasia or hypoplasia are more common than the other types. Although there are some reports about paranasal sinus anomalies in the literature, there is no case similar to ours, with total paranasal sinus aplasia. Here, we present a unique case of total paranasal sinus aplasia with a symptom of fullness on the face.