Surgical and Radiologic Anatomy

, Volume 40, Issue 7, pp 847–853 | Cite as

Vertical and sagittal combinations of concha bullosa media and paradoxical middle turbinate

  • C. J. Sava
  • M. C. Rusu
  • M. Săndulescu
  • D. Dincă
Anatomic Variations


Common anatomic variants of the middle nasal turbinate include its pneumatization (i.e. concha bullosa media) and its paradoxical curvature. We report here two cases of differently combined variations of the middle turbinate which were documented in cone beam computed tomography (CBCT). The first report presents the vertical combination of a double or septated lamellar concha bullosa with the paradoxical curvature of middle turbinate. This combined variant associated (coincidental findings): ipsilateral paradoxical superior turbinate and contralateral paradoxical middle turbinate, concha bullosa superior and concha bullosa suprema. In the second case was found the sagittal combination of successive anterior concha bullosa media and posterior paradoxical curvature of the middle turbinate. An ethmoidal sinolith was found embedded in lamella basalis. The contralateral superior turbinate was pneumatized. These rare findings demonstrate that sound knowledge of possible anatomical variations, supported by a complete use of the tools available for the CBCT documentation of cases, is able to enrich the picture of human anatomic variations, with a direct impact on clinical and surgical practice. The septa-containing lamellar concha bullosa and paradoxical middle concha combination is a variation that affects surgical practice.


Anatomic variation Nasal turbinate Nasal fossa Conchal pneumatization Ethmoidal sinolith 


Author contributions

CJS: data collection and management, manuscript writing; MCR: protocol/project development, data analysis, documented specific literature, approved the final version of manuscript. MS: CBCT documentation of data, manuscript and figures editing. DD: reviewed the case, reviewed the manuscript for critical contents, contributed to discussions.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • C. J. Sava
    • 1
  • M. C. Rusu
    • 2
  • M. Săndulescu
    • 3
  • D. Dincă
    • 4
  1. 1.Division of Anatomy, Faculty of Medicine“Victor Babeş” University of Medicine and PharmacyTimișoaraRomania
  2. 2.Division of Anatomy, Faculty of Dental Medicine“Carol Davila” University of Medicine and PharmacyBucharestRomania
  3. 3.Division of Oral Implantology, Faculty of Dental Medicine“Carol Davila” University of Medicine and PharmacyBucharestRomania
  4. 4.Department II of Surgical Clinical Divisions, Faculty of Medicine“Ovidius” UniversityConstanţaRomania

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