Is a paradoxical middle turbinate a medical condition? Is it normal or do I need to see ENT? (Photo)

Question

My CT scan.. are the middle turbinates normal? Septum has a bend is that normal? I went to a PS said I had a deviated septum, enlarged turbinated, sent to insurance and denied..no evidence of Dr appointments to need surgery. I do have light headaches between my eyes most days. Thanks for your time! Much appreciated!!

William Portuese, MD · Answer

It is best to see an ENT surgeon who can address the functional issues going on inside  the sinuses, obtain a complete history of all the sinus and nasal issues, perform an examination of the internal portion of the nose and then given accurate interpretation of the CAT scan in relation to your symptoms. The photographs demonstrate  only 2 views out of approximately 30  views of the sinuses when a CAT scan is performed. These limited 2 views show a straight septum, enlarged middle and inferior turbinates, and polyps noted in the maxillary sinuses on both sides immediately above the tooth roots. An examination of all the scans are required to make any determination about endoscopic sinus surgery. An  ENT/ facial plastic surgeon can address both functional and cosmetic surgery on the nose, if so desired.

Jawed Tahery, FRCS · Answer

Hi,If you have symptoms of chronic rhinosinsusits such as stuffiness, blockage, pressure between your eyesand/or if you get a cold and afterwards your are blocked for ever you may benefit from opening of your sinuses, however headaches on his own is usually not related to sinuses!in the abscens of above mentiond symptoms I would leave your scans/ sinuses alone!!bwJawed TaheryENT/Facial plastic surgeonchester,uk

Peter A. Aldea, MD · Answer

From the image provided you have minor septal deviation and enlarged turbinates. In my opinion this is not an overwhelming indication for surgery without a history that you do not have allergies and trial of conservative therapy. All of us have seen similar radiological presentations which were managed well without surgery. Swelling of the turbinates is often due to allergic issues which are never treated by surgery. I would recommend  you consult a great Allergist and see if he/she could help you. Good Luck.

Mark Loury, MD, FACS (retired) · Answer

This view shows more of a bulky curve on the middle turbinates and not paradoxical curvature. The normal MT has a gentle "c" curve whereas paradoxical has an"s" shape which can narrow the space into which the anterior ethmoid, frontal, and maxillary sinuses drain and potentially cause sinus problems. You also have an accessory ostium on the right into the maxillary sinus. These are posterior to the natural opening and can be an indication that the natural drainage pathway is dysfunctional causing maxillary sinusitis. Your superior turbinates are wedged against the upper septum and may be the cause of your headaches but other causes such as tension, migraine, etc need to be excluded. I would suggest seeing an ENT skilled in sinus disease management

Is a paradoxical middle turbinate a medical condition? Is it normal or do I need to see ENT? (Photo)

Answers (4)

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