Commentary on: "Evaluation of variations in sinonasal region with computed tomography".

This letter is a commentary on the article titled "Evaluation of variations in sinonasal region with computed tomography", published in the January 2016 issue of World Journal of Radiology. The authors definition of the secondary middle turbinate is incorrect. The authors stated that the secondary middle turbinate is an accessory turbinate that is seen between the superior and middle turbinates. It should originate from the middle meatus posterosuperior to the ethmoid infundibulum.

Core tip: This letter is a commentary on the article titled “Evaluation of variations in sinonasal region with computed tomography,” published in the January 2016 issue of World Journal of Radiology. The authors evaluated the paranasal sinus tomography of 400 patients to determine the frequency of 39 anatomic variations. Their study required a great deal of time and effort. Unfortunately, their definition of the secondary middle turbinate and the figure that showed its structure are incorrect. It should originate, however, from the middle meatus posterosuperior to the ethmoid infundibulum, not from between the middle and superior turbinates.

TO THE EDITOR

I read the article by Dasar et al[1] with great interest. The authors evaluated the paranasal sinus tomography of 400 patients to determine the frequency of each of 39 possible anatomic variations. Their study required a great deal of time and effort. Unfortunately, their definition of the secondary middle turbinate and the figure that showed its structure are incorrect.

The authors stated that the secondary middle turbinate is an accessory turbinate that is seen between the superior and middle turbinates[1]. It should originate, however, from the middle meatus posterosuperior to the ethmoid infundibulum, not from between the middle and superior turbinates[2]. The secondary middle turbinate is not part of the middle turbinate. The appearance of a secondary middle turbinate is probably due to the partial absence of the anterior wall of the ethmoidbulla[2].

Their figure 3D, which was used to illustrate the secondary middle turbinate, is also not appropriate. A sagittal cleft on the middle turbinate is seen in this figure, which is not an appropriate example for the secondary middle turbinate. The secondary middle turbinate is actually a bony prominence that extends from the lateral nasal wall to the middle meatus, as shown in Figure 1[2].

Figure 1

Secondary middle turbinate is apparent on the right side of the figure. smt: Secondary middle turbinate; mt: Middle turbinate.