Middle turbinate concha bullosa osteoma: A comprehensive review of all reported cases

Abstract

Introduction: Osteomas are benign, slow growing tumours of bone. Recently, a number of reports have emerged describing osteomas within concha bullosa of the middle turbinate (MT) as rhinogenic sources of headache. Objective: Our objective was to summarize literature on presentation of osteomas within MT concha bullosa in order to inform management. Methods: All reports with osteoma located within the MT concha bullosa on imaging were included in the review of English literature through September 2020. Results: Eight documented cases of osteomas localized within MT concha bullosa were identified through the review along with our Case presentation. The majority of patients were female with a mean age of 43.0. Median size was 19.9 mm at presentation. In previous reports, headaches led to the discovery of the concha bullosa osteoma. However, our patient presented with ipsilateral nasal obstruction. If patients consented to surgery, all osteomas were approached endoscopically leading to resolution of presenting symptoms. Conclusion: Our Case report adds to the current literature by demonstrating that concha bullosa osteomas can present in absence of headaches. Location within concha bullosa presents an opportunity for endoscopic resection. The size of the osteoma guided MT preservation.

Keywords

• Middle turbinate osteoma
• Concha bullosa
• Endoscopic sinus surgery
• Headaches
• Rhinogenic headaches
• Nasal obstruction