Norouzi Shohreh, Tabibzadeh Seyyed Mohammad, Zarei Milad, Kiani Ayeh
Department of Otolaryngology - Head and Neck Surgery, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran.
Iran J Otorhinolaryngol. 2021 Nov;33(119):395-398. doi: 10.22038/IJORL.2021.55647.2917.
Concha bullosa is a usual anatomical variation of the nose and paranasal sinuses that can compromise their anatomy and function and cause such symptoms as headache, rhinosinusitis, and nasal congestion. Septal perforation is the defect of the septum that brings nasal cavities in communication and is usually caused by trauma. No septal perforation has been reported due to concha bullosa.
The case of this report was a 15-year-old female who presented with long-term nasal obstruction due to a huge concha bullosa in her right nasal cavity which perforated nasal septum. She lacked a history of any nasal septum surgery, drug abuse, cocaine, or long-term nasal spray. Endoscopic surgery was performed and our patient's symptoms rapidly diminished after the surgery. Negative results were obtained for tuberculosis, Wegener's granulomatosis disease, and malignancy.
We believe that the concha bullosa presented in this case might have caused chondrocyte apoptosis due to mechanical pressure and led to septal perforation. Although uncommon, providers should be aware of the possibility of septal perforation in cases with concha bullosa when planning to perform surgery on patients with similar pathology.
泡状鼻甲是鼻和鼻窦常见的解剖变异，可影响其解剖结构和功能，并引起头痛、鼻窦炎和鼻塞等症状。鼻中隔穿孔是鼻中隔的缺损，可使鼻腔相通，通常由外伤引起。尚未有因泡状鼻甲导致鼻中隔穿孔的报道。
本报告的病例为一名15岁女性，因右侧鼻腔巨大泡状鼻甲导致鼻中隔穿孔而长期鼻塞。她没有鼻中隔手术、药物滥用、可卡因或长期使用鼻喷雾剂的病史。进行了内镜手术，术后患者症状迅速减轻。结核、韦格纳肉芽肿病和恶性肿瘤的检查结果均为阴性。
我们认为本病例中的泡状鼻甲可能由于机械压力导致软骨细胞凋亡，进而导致鼻中隔穿孔。尽管不常见，但在为具有类似病理的患者计划手术时，医生应意识到泡状鼻甲患者发生鼻中隔穿孔的可能性。
