title: Anatomical variations of the lateral nasal wall: The secondary and accessory middle turbinates.
abstract: The aim of the current anatomical and clinical study was to audit our cases of patients who presented with secondary and/or accessory middle turbinates during a two-year period. We investigated the incidence and the clinical impact of these variations. Twenty-eight patients, 19 males and 9 females with a mean age of 41.5 years, representing different ethnic origins, were diagnosed with double middle turbinates based on endoscopic examination. Of those, 92.8% had a main symptom of refractory frontal headache. A secondary nasal symptom was sensation of blocked nose. Patients who underwent endoscopic surgery (n = 13) for reduction of the extra turbinate, reported significant symptom scores improvement (P < 0.0001) of frontal headache and blocked nose, from means of 9.07 ± 0.26 and 8.57 ± 1.39 to 1 ± 0.31, and 1.42 ± 0.35, respectively. Our results indicate that double middle turbinates may be encountered in rhinology practice (2%). Clinically they may present with refractory headache and blocked nose. Endoscopic surgical approach seems to be an effective way of improving the symptoms.
authors.affiliation: Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Liege University Hospital (Centre hospitalier Universaitaire-C.H.U.), Liege, Belgium. amrel_shazly@hotmail.com
authors.forename: A E
authors.initials: AE
authors.lastname: El-Shazly
authors.forename: Anne-Lise
authors.initials: AL
authors.lastname: Poirrier
authors.forename: J
authors.initials: J
authors.lastname: Cabay
authors.forename: P P
authors.initials: PP
authors.lastname: Lefebvre
mesh_terms: D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000627:therapeutic use; D005260:Female; D014644:Genetic Variation; D006261:Headache / Q000209:etiology / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000033:anatomy & histology*; D014663:Nasal Decongestants / Q000627:therapeutic use; D015508:Nasal Obstruction / Q000150:complications / Q000473:pathology / Q000628:therapy; D010148:Intractable Pain / Q000209:etiology / Q000473:pathology / Q000628:therapy; D011859:Radiography; D012852:Sinusitis / Q000150:complications / Q000473:pathology / Q000628:therapy; D014420:Turbinates / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D014663:Nasal Decongestants