A case of uncommon anatomic variation of the middle turbinate associated with contact point headache: Bilateral double middle turbinate.

Abstract

By applying pressure to nasal mucosa, anatomic variations at nasal cavity and paranasal sinuses may cause headache without any sign of inflammatory diseases such as sinusitis or nasal polyp. This phenomenon is called as contact point headache (CPH) and observed as a result of concha variations, mostly due to concha bullosa. Accessory middle turbinate (AMT) is a very rare variation and occurred as a result of mediale and inferior folding of uncinate process. When this folding is severe, AMT may cause double middle concha appearance in nasal cavity. To the extent, we know, bilateral double middle turbinate variation has not been defined before. Hereby, we present a CPH phenomenon in a patient with bilateral double middle turbinate variation which is related to contact of AMT to real middle turbinate.