Pneumatization of Turbinates

• Published in: The Laryngoscope 2003-04, Vol.113 (4), p.668-672
• Main Authors: Braun, Hannes, Stammberger, Heinz
• Format: Article
• Language: English
• Subjects: Adult; Air; anatomical variations; Biological and medical sciences; computed tomography scan; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Female; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; inferior turbinate; Medical sciences; Non tumoral diseases; Otorhinolaryngology. Stomatology; Paranasal Sinus Diseases - diagnostic imaging; Paranasal sinuses; pneumatization; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; Tomography, X-Ray Computed; Turbinates - diagnostic imaging
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1097/00005537-200304000-00016

Objectives To present unusual computed tomography (CT) findings concerning huge pneumatization of turbinates and paranasal sinuses in one patient. In current world literature the authors only found nine reports of pneumatization of inferior turbinates, which, therefore, must be considered an extremely rare anatomical finding. Study Design Case report and literature review. Methods Computed tomography findings in a 35‐year‐old white woman with nasal obstruction are presented; and the authors describe this additional case of pneumatization of an inferior turbinate, as well as other variants. The literature and nomenclature are reviewed. Results Besides the rare anatomical finding of a pneumatized inferior turbinate, in addition, both patient middle and superior turbinates were pneumatized bilaterally. Frontal and sphenoid sinuses were huge, with pneumatization of the crista galli and the posterior parts of the septum. The floor of the orbit presented with an orbitoethmoid (Haller) cell on one side. Thus, five of the six turbinates present were pneumatized. To the authors' knowledge, no other case of such extreme pneumatization has been published in world literature to date. Conclusions Whereas pneumatization of the ethmoturbinals is a frequent finding on sinus computed tomography scans, pneumatization of the maxilloturbinal remains an extremely rare anatomical variant. Pneumatization of ethmoid cells and secondary sinuses is considered an active achievement of nasal and sinus mucosa during fetal development and adolescence. The underlying mechanisms of this process are not yet understood. The inferior turbinate is the least likely to present with pneumatization. In clinical practice, the pneumatization status should well be studied on the scans before any sinus and turbinate surgery is undertaken.