In recent years, with the widespread use of imaging techniques such as paranasal sinus computed tomography (CT), many variations of nasal turbinates have been described. One of these variations known as concha bullosa (CB) is pneumatization of nasal turbinates. CB is the most frequently encountered anatomical variations of the middle turbinate. The term of septated concha bullosa has been described recently and it is an uncommon pneumatization anomaly of the middle turbinate. There has not been any study that correlates the number of septations and the presence of sinonasal pathologies. We hereby present a case of triple septated concha bullosa that has not been reported so far. 1. Introduction Concha Bullosa (CB) is called partial or total pneumatization of the middle turbinate. CB is the most common anatomic variation of osteomeatal complex region that is generally seen in the middle turbinate, and rarely in the superior and inferior turbinate as well [1–3]. The exact reason of pneumatization of the middle turbinate is unknown. Although usually asymptomatic, an overpneumatized middle turbinate may constitute mass and in cases with impaired ventilation and drainage of osteomeatal region it can give rise to sinusitis. CB has first been described by Zuckerkandl in 1893 [4]. As far as we know, there is no publication related to triple divided CB in the literature. We report an uncommon anatomic variation in connection with concha bullosa pneumatization. 2. Case Report A-75-year old woman was admitted to our clinic with nasal obstruction and headache symptoms that had been going on for 10 years. In nasal anterior rhinoscopic and endoscopic examination, hypertrophy of the right middle turbinate and inferior turbinate were present. The patient suffered mostly from obstruction of right nasal cavity. Anterior rhinomanometry was performed after decongestion of the nose and a significant decrease in the nasal resistance was observed. A coronal plane CT demonstrated two thin bony septums inside the CB cavity and the hypertrophy of inferior turbinate in the right side and lamellar-type CB in the left side as well (Figure 1). Thus, CB cavity was divided into three cells. There was no attachment to the middle nasal meatus or sinus lateralis. Figure 1: Coronal CT scan showing two thin bony septums inside the CB cavity and hypertrophy of inferior turbinate in the right side, besides lamellar type CB in the left side. 3. Discussion The incidence of concha bullosa is 13–53%; anterior ethmoidal cells and posterior ethmoidal cells are responsible for pneumatization of CB
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