Bilateral pneumatization of middle and superior nasal turbinates

The pneumatization of all nasal turbinates is an extremely rare finding. Several previous reports have presented the bilateral superior, middle, and inferior conchæbullosæ. We report the bilateral pneumatization of middle and superior nasal turbinates. The variant was documented in cone beam computed tomography (CBCT) in all three dimensions. The inferior concha bullosa was a bilaterally moderate subtype of lamellar pneumatization that presented as a conchal recess of the maxillary sinus. The concha bullosa media was bilaterally of the extensive or true type and associated unilaterally with an uncinate bulla. The concha bullosa superior was asymmetrical bilaterally, narrower on the right side, and larger on the left where it was also septated and tri-cameral. The supreme conchæ were rudimentary, as were their pneumatizations. For an accurate anatomic diagnosis of conchæbullosæ in computed tomography, sagittal, coronal, and axial cuts, as well as three-dimensional reconstructions, should be used to ensure adequate planning of functional endoscopic sinus surgery.