Subdural empyema complicating a concha bullosa pyocele

International Journal of Paediatric Otorhinolaryngology Volume 65, Issue 3, Pages 249-252 (24 September 2002)
Rémi Marianowskiab, Marcello Farragia, Michel Zerahc, Francis Brunelled, Yves Manacha 
a Department of Pediatric Otorhinolaryngology, Hôpital Necker Enfants Malades, Paris, France
b Department of Otorhinolaryngology, Hôpital Morvan, 5 Avenue Foch, 29200 Brest, France
c Department of Pediatric Neurosurgery, Hôpital Necker Enfants Malades, Paris, France
d Department of Pediatric Radiology, Hôpital Necker Enfants Malades, Paris, France
Received 15 February 2002; received in revised form 22 May 2002; accepted 27 May 2002.

Abstract 
Concha bullosa is the most common anatomic variant of the middle turbinate and remains usually asymptomatic. We report a case of concha bullosa pyocele with a subdural empyema in a 11-year-old girl presenting with a subcutaneous tumefaction without neurologic deficit. Computed tomography and magnetic resonance imaging confirmed a subdural empyema communicating with subcutaneous effusion and the presence of a concha bullosa pyocele being responsible for the obstruction of ostiomeatal complex leading to frontal sinusitis. Resection of the middle turbinate with a middle meatotomy and a frontal skin incision combined with an adequate antibiotic treatment allowed this child to recover within 6 weeks.