Giant Pneumatized Ethmoid Bulla: A Rare Anatomical Variation

Pneumatization of the Ethmoid bulla varies greatly, and anatomical variations of the paranasal sinuses are quite common. However, giant ethmoid bulla prevalence in the published literature is relatively low. A 38-year-old woman presented with nasal obstruction and recurrent attacks of rhinosinusitis. The endoscopic examination showed a deviated nasal septum to the left, edematous left middle meatus, and hypertrophied inferior turbinates. The CT scan of the paranasal sinuses revealed an enlarged pneumatized ethmoid bulla, S-shaped nasal septum, bilateral inferior nasal turbinates hypertrophy, and obstructed left ostiomeatal complex (OMC), whereas the right OMC was patent. The patient underwent septoplasty and limited functional endoscopic sinus surgery. All symptoms were alleviated, and the patient remained symptom free after 6 months. Prospective studies should evaluate patients with sinonasal manifestations with radiologic evaluation complemented by nasal endoscopy to detect and rule out anatomical variations of the OMC region as a causative agent.