title: [Concha bullosa and the nasal middle meatus obstructive syndrome].
abstract: BACKGROUND
  Concha bullosa (CB) is pneumatization of the middle turbinate and one of the most common anatomic variation of the sinonasal region. It is found in about 25% of the population. Middle meatus obstructive syndrome (MMOS) is, usually connected with CB. The main symptoms of this syndrome are headaches, impaired nasal breathing and hyposmia. Headache is the most common symptom and it may occur due to contact between a CB and other structures of the nasal cavity.
  
  
  METHODS
  We presented a case of 32 year-old-woman with headaches, located in the orbital and the left frontal region. The headaches were intermittent and corresponding to the nasal cycle. After neurologic and allergic examination, endoscopic nasal examination demonstrated a septal deviation to the right side and a large middle turbinate in the left side of the nasal cavity. Coronal computerized tomography (CT) of the paranasal sinuses demonstrated the septal deformation and pneumatization of the left middle turbinate. Diagnosis was confirmed by lidocaine test. In the functional endoscopic surgery (FESS), the lateral lamela of the anterior CB was removed. At the same time, the septoplasty was done. At the control examination, the patient was without symptoms.
  
  
  CONCLUSIONS
  Although CB is the common anatomic variation of the nasal cavity, MMOS is rare. Headache (rhinogenic origin) is the most important symptom. Surgical treatment is the lateral resection of the CB in the FESS technique and the septoplasty.
authors.affiliation: Vojnomedicinska akademija, Klinika za otorinolaringologiju, Beograd, Srbija. alexneta@net.yu
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Perić
authors.forename: Jelena
authors.initials: J
authors.lastname: Sotirović
authors.forename: Nenad
authors.initials: N
authors.lastname: Baletić
authors.forename: Ruzica
authors.initials: R
authors.lastname: Kozomara
authors.forename: Dusan
authors.initials: D
authors.lastname: Bijelić
authors.forename: Dejan
authors.initials: D
authors.lastname: Rasić
mesh_terms: D000328:Adult; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D015508:Nasal Obstruction / Q000209:etiology*; D009300:Nasal Septum / Q000473:pathology; D013577:Syndrome; D014420:Turbinates / Q000473:pathology*