Paradoxical middle turbinate

Last revised by Mostafa Elfeky on 13 Dec 2022

Paradoxical middle turbinate is a rare developmental cause of nasal obstruction. It refers to an inferomedially curved middle turbinate edge with the concave surface facing the nasal septum and usually occurs bilaterally.


Paradoxical middle turbinate is a rarely encountered anomaly and can be easily recognized in CT paranasal sinuses but can be overlooked on endoscopic examination 3.

The prevalence reported by different authors may diverge because some of them consider any involved portion of the turbinate as paradoxical curvature, whereas others may consider this variation only in cases where the whole turbinate is unusually curved towards the opposite side 4.

Another study indicated paradoxical middle turbinate represents 9% of total anatomical variations.

Radiographic features

This anatomic variant alone can lead to significant narrowing of the middle nasal meatus and impede the normal drainage of paranasal sinuses due to ostiomeatal complex obstruction 2. When associated with a concha bullosa, it can potentially lead to nasal obstruction 2.

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