Cirugía de cornetes inferiores en población pediátrica: ¿Cómo, cuándo y por qué?

La hipertrofia de cornetes inferiores representa una de las principales causas de obstrucción nasal en pacientes pediátricos. En estudios recientes se ha observado un aumento significativo de esta patología en niños que no responden a terapia médica. La evidencia disponible recomienda la cirugía como tratamiento de elección en la obstrucción nasal refractaria en niños con cornetes hipertróficos. Sin embargo, hasta la fecha no existen criterios formales de derivación a cirugía en la población pediátrica y los estudios en infantes son limitados. Al mismo tiempo, la falta de consenso no ha permitido recomendar una técnica quirúrgica en estos pacientes por sobre otras. Por lo tanto, se hace necesario profundizar las diferentes alternativas disponibles, considerando y optando por aquellas que presenten mayores beneficios y menor riesgo de complicaciones. En la presente revisión se estudió la evidencia disponible hasta el momento sobre este tema en la población pediátrica y además se realizó un análisis de la efectividad y complicaciones de las diferentes técnicas disponibles.

Inferior turbinate hypertrophy represents one of the leading causes of nasal obstruction in pediatric patients. Recent studies have observed a significant increase in turbinate hypertrophy in children that does not respond to medical treatment. The latest evidence recommends inferior turbinoplasty for treating nasal obstruction in children with hypertrophic turbinates. However, until today there are no formal criteria for referral to surgery in the pediatric population, and studies in children are limited. At the same time, the absence of consensus has not allowed the recommendation of one surgical technique over others in these patients. This is why it is necessary to deepen the available alternatives and choose those with more significant benefits and a lower risk of complications. In this review, we study available evidence about this topic in the pediatric population and analyze the effectiveness and complications of different known techniques.

Early clinical outcomes of ınferior turbinate radiofrequency and lateralization combined with septoplasty / Resultados clínicos iniciais da utilização de radiofrequência e lateralização das conchas nasais inferiores combinadas à septoplastia

Abstract Introduction: Mechanical obstruction is the most common form of nasal obstruction. Among the types of mechanical obstructions, septum deviation and inferior turbinate hypertrophy are the most prevalent. Objective: This study evaluated the early clinical outcomes of inferior turbinate radiofrequency and inferior turbinate lateralization combined with septoplasty in the treatment of nasal obstruction symptoms. Methods: The research retrospectively evaluated data from 33 patients (24 male, nine female) undergoing septoplasty and inferior turbinate radiofrequency (RF group) and 32 patients (24 male, eight female) treated with septoplasty and inferior turbinate lateralization (LAT group), who were admitted, with complaints of nasal obstruction, to the University of Health Sciences, Department of Otorhinolaryngology, between January 1, 2017 and January 1, 2018. The patients' preoperative and 6-month postoperative symptoms were evaluated via the Nasal Obstruction Symptom Evaluation, the NOSE scale. Results: The mean preoperative NOSE scores were 10.3 ± 4.2 in the RF group and 10.9 ± 4.9 in the LAT group, and the mean six-month postoperative scores were 1.09 ± 1.3 in the RF group and 1.2 ± 1.3 in the LAT group. There was no significant difference in NOSE scores between the two groups (p > 0.05). Conclusion: The data obtained in this study show that both methods result in similar outcomes in terms of relieving nasal obstruction symptoms in patients requiring inferior turbinate intervention. Therefore, the researchers believe that, in each case, the intervention method should be selected at the discretion of the patient and surgeon(s).

Resumo Introdução: A obstrução mecânica é a forma mais comum de obstrução nasal. Entre os tipos de obstruções mecânicas, o desvio do septo e a hipertrofia de conchas inferiores são os mais prevalentes. Objetivo: Avaliar os resultados clínicos iniciais da aplicação de radiofrequência nas conchas inferiores e a lateralização delas combinada com septoplastia no tratamento dos sintomas de obstrução nasal. Método: O estudo avaliou retrospectivamente dados de 33 pacientes (24 homens, nove mulheres) que foram submetidos a septoplastia e aplicação de radiofrequência no concha inferior (grupo RF) e 32 pacientes (24 homens, oito mulheres) submetidos a septoplastia e lateralização de concha inferior (grupo LAT), que foram admitidos com queixas de obstrução nasal na University of Health Sciences, Departamento de Otorrinolaringologia, entre 1° de janeiro de 2017 e 1° de janeiro de 2018. Os sintomas pré-operatórios e pós-operatórios de 6 meses dos pacientes foram avaliados pela escala NOSE, do inglês Nasal Obstruction Symptom Evaluation. Resultados: Os escores médios pré-operatórios da escala NOSE foram 10,3 ± 4,2 no grupo RF e 10,9 ± 4,9 no grupo LAT e os escores médios pós-operatórios de seis meses foram 1,09 ± 1,3 no grupo RF e 1,2 ± 1,3 no grupo LAT. Não houve diferença significante nos escores da escala NOSE entre os dois grupos (p > 0,05). Conclusão: Os dados obtidos neste estudo mostram que ambos os métodos têm resultados semelhantes em termos de alívio dos sintomas de obstrução nasal em pacientes que necessitam de intervenção nas conchas inferiores. Portanto, os pesquisadores acreditam que, em cada caso, o método de intervenção deve ser selecionado a critério do paciente e do cirurgião.

Changes in substance P levels of inferior turbinate in patients with mucosal contact headache / Alterações nos níveis da substância P da concha inferior de pacientes com cefaleiapor ponto de contato da mucosa

Abstract Introduction Mucosal contact headache is a referred pain that arises from contact between the nasal septum and the lateral nasal wall. Evidence supports the role of substance P in a contact headache such that release of substance P from sensory nerve endings causes inflammation and allergy. Objectives This study aimed to determine possible differences in substance P levels in inferior turbinate hypertrophy creating a contact headache. Methods 28 patients who had contact headaches (study group) and 16 volunteers with no complaints were included in the study. Substance P levels in the inferior turbinate tissue samples were quantified using a commercially available substance P EIA kit. Results In the study group average substance P levels were 2.65 ± 0.27 pg/mg tissue (range: 0.61-5.44) and in the control group it was 1.77 ± 0.27 pg/mg tissue (range: 0.11-4.35). The difference was statistically significant between the two groups (p = 0.0215). Average preoperative headache group visual analog scale scores was 5.93 ± 0.38 (2-9) and the turbinate volume was 6.56 ± 0.35 cm3 (3.50-10.30). The control group turbinate volume was 4.71 ± 0.39 cm3 (2.50-7.70). We found a correlation between the visual analog scale scores and substance P levels such that substance P levels were higher in visual analog scale scores above 5 (p = 0.001). Conclusion This study demonstrates the relationship between intranasal contact headaches and increased mucosal substance P levels. We also found that there is no correlation with substance P levels and volume of the inferior turbinate.

Resumo Introdução A cefaleia por ponto de contato da mucosa é uma dor direcionada que surge do contato entre o septo nasal e a parede nasal lateral. Evidências corroboram o papel da substância P na cefaleia de contato, de tal forma que a liberação da mesma a partir de terminações nervosas sensoriais possa causar inflamação e alergia. Objetivo Determinar possíveis diferenças nos níveis da substância P na hipertrofia de conchas inferiores em relação à cefaleia de contato. Método Foram incluídos no estudo 28 pacientes que apresentaram cefaleia por ponto de contato (Grupo Estudo) e 16 voluntários sem queixas. Os níveis de substância P nas amostras de tecido da concha inferior foram quantificados com um kit substância P EIA, comercialmente disponível. Resultados No grupo do estudo, os níveis médios de substância P foram 2,65 ± 0,27 pg/mg de tecido (variação: 0,61-5,44) e no grupo controle foram de 1,77 ± 0,27 pg/mg de tecido (variação: 0,11-4,35) e a diferença foi estatisticamente significante entre os dois grupos (p = 0,0215). O escore médio da escala visual analógica do grupo de cefaleia pré-operatória foi de 5,93 ± 0,38 (2-9) e o volume das conchas foi de 6,56 ± 0,35 cm3 (3,50-10,30). O volume da concha do grupo controle foi de 4,71 ± 0,39 cm3 (2,50 ± 7,70). Encontramos uma correlação entre o escore da escala visual analógica e os níveis de substância P, de modo que os níveis de substância P foram maiores nos escores da escala visual analógica acima de 5 (p = 0,001). Conclusão Este estudo demonstra a relação entre cefaleias por contato intranasais e níveis aumentados de substância P nas mucosas. Também observamos que não há correlação com os níveis de substância P e o volume da concha inferior.

Hipertrofia de cornetes inferiores: revisión sobre técnicas quirúrgicas actuales / Inferior turbinate hypertrophy: review of current surgical techniques

La obstrucción nasal es un motivo de consulta habitual en otorrinolaringología, siendo una de las causas más frecuentes la hipertrofia de cornete inferior, la que se puede manejar con cirugía cuando falla el tratamiento médico. En las últimas décadas se han desarrollado múltiples técnicas quirúrgicas y tecnología asociada, sin embargo, no hay un consenso establecido sobre cuál es la mejor opción para el manejo de esta patología. Se realizó revisión bibliográfica, se enuncian los métodos quirúrgicos disponibles, teniendo en cuenta beneficios, complicaciones probables y resultados de cada uno. La cirugía de cornete inferior tiene resultados favorables en pacientes con cornetes hipertróficos que no responden a manejo médico. Hasta la fecha la turbinoplastía con microdebridador ha mostrado superioridad en cuanto a resultados a largo plazo y menor tasa de complicaciones. La evidencia disponible hasta la fecha carece de homogeneidad en cuanto a métodos de selección de pacientes, medición de resultados y tiempo de seguimiento, por lo que se necesitan a futuro estudios prospectivos controlados para reevaluar los métodos descritos.

Nasal obstruction is a common complaint, one of the most frequent causes being inferior turbinate hypertrophy, which can be managed with surgery when medical treatment fails. In the last decades, multiple surgical techniques and associated technology have been developed, however, there is no established consensus on what is the best option for the management of this pathology. Literature review, the available surgical methods are stated, taking into account benefits, probable complications and results of each technique. The surgery of inferior turbinate has favorable results in patients with hypertrophic turbinates that do not respond to medical management. To date, microdebrider turbinoplasty has shown superiority in terms of long-term results and lower complication rates. The evidence available to date lacks homogeneity in terms of patient selection methods, measurement of results and follow-up time, so prospective controlled studies are needed in the future to reassess the described methods.

Reversible Endoscopic Medial Maxillectomy: Endonasal Approach to Diseases of the Maxillary Sinus

Abstract Introduction The endoscopic access has reduced the morbidity associated with external approaches in diseases of themaxillary sinus. A reversible endoscopic medialmaxillectomy (REMM) is presented as an alternative for treatment of benign maxillary diseases. Objective To describe the REMM technique and report four cases of patients with benign maxillary sinus conditions treated through this approach. Methods The present study was divided into two parts: anatomical and case series. Two cadaveric dissections confirmed the feasibility of the REMMapproach. The same technique was performed on four consecutive patients with benign maxillary sinus disease. Results The cadaveric dissections confirmed wide exposure to the maxillary cavity, preserving the anatomy of the maxillary sinus. In the patient series, one patient presented with an antrochoanal polyp, one had a silent sinus syndrome, one had a chronic maxillary sinusitis secondary to a gunshot, and the last one had an inverted papilloma in the maxillary sinus. In all of the cases, the REMM approach provided excellent access and adequate resection, as well as preservation of the inferior turbinate, nasolacrimal duct, and lateral wall of the nose (including its osteomucosal component). Finally, all of the patients had an uneventful postoperative course. Conclusion The REMM technique is an excellent surgical approach to benign conditions of the maxillary sinus. It has few limitations and appears to be associated with less morbidity than conventional techniques.

Radiologic study of the nasal septal swell body and its relationship to septal deviation

Objective@#To compare the radiographic features of the nasal septal swell body (NSB) with the laterality of nasal septal deviation and investigate whether there is a correlation between the severity of the septal deviation and difference in NSB size.@*Methods@#Design: Retrospective Observational Study. Setting: Tertiary Private University Hospital. Participants: 30 paranasal sinus computerized tomography scans from January to October 2017.@*Results@#A septal deviation was present in 60% of the subjects. In 78% of cases with septal deviation, the NSB was noted to be significantly larger on the side opposite the nasal septal deviation (p < .05). @*Conclusion@#The correlation between the severity of the septal deviation and difference in NSB size had a value of (r = 0.37) therefore, no positive correlation was established. Subjects with almost symmetric NSB measurements tend to have no septal deviation. On the other hand, the NSB is more prominent contralateral to a septal deviation.

Epithelial-Myoepithelial Carcinoma of the Inferior Turbinate: A Case Report

Usefulness of Inferior Turbinate Bone-Periosteal-Mucosal Composite Free Graft for Cerebrospinal Fluid Leakage

BACKGROUND AND OBJECTIVES: Endoscopic repair of cerebrospinal fluid (CSF) leak can avoid morbidity of open approaches and has shown a favorable success rate. Free mucosal graft is a good method, and multi-layered repair is more favorable. The inferior turbinate has been commonly utilized for the free mucosal graft, but we newly designed it as a bone-periosteal-mucosal composite graft for multilayered reconstruction. SUBJECTS AND METHOD: Four subjects with a skull base defect were treated with this method. The inferior turbinate was partially resected including the conchal bone and was trimmed according to defect size. Both bony parts and periosteum were preserved on the basolateral side of the mucosa as a composite graft. The graft was applied to the defect site using an overlay technique. RESULTS: All cases were successfully repaired without any complications. Three of them had a defect size greater than 10–12 mm, and the graft stably repaired the CSF leakage. CONCLUSIONS: Endoscopic repair of CSF leakage using inferior turbinate composite graft is a simple and easy method and would be favorable for defect sizes greater than 10 mm.

A Case of Osteoblastoma Accompanied with Concha Bullosa of the Inferior Turbinate / 대한이비인후과학회지

Osteoblastoma is a rare benign tumor, representing less than 1% of all bone tumors. Most cases occur in the vertebrae and in the long bones. Intranasal or paranasal osteoblastoma is particularly rare and only one case of osteoblastoma in the inferior turbinate has been reported in the world literature. Treatment is intralesional curettage or en bloc resection. Since the tumor is benign, conservative surgery is curative in about 80-90% of the cases. Concha bullosa is an abnormal pneumatization of the intranasal turbinates and inferior concha bullosa is a very rare condition. We report an unusual case of osteoblastoma occurring together with inferior concha bullosa. The tumor and inferior concha bullosa were removed by endoscopic submucosal inferior turbinoplasty, with favorable results. Related articles are reviewed and brief discussions are presented in regards to the case findings.

A Rare Location of Angiofibroma in the Inferior Turbinate in Young Woman

Introduction Juvenile nasopharyngeal angiofibroma is a rare benign neoplasm in the nasopharynx. The tumor tends to be locally aggressive and is typically seen in adolescent boys. Extranasopharyngeal angiofibromas have been reported sporadically in the literature. They most commonly originate from the maxillary sinus. Objectives A 26-year-old woman was referred to our clinic with intermittent epistaxis from the right nasal passage for the previous 2 months. Maxillofacial magnetic resonance imaging showed a lobular, contoured mass originating from the right inferior turbinate and hanging in the right nasal cavity, with dense contrast enhancement denoting hypervascularity. Resumed Report Vascular feeding of the mass was seen from the right internal maxillary artery with angiography, and this branch was embolized. On the following day, the patient underwent transnasal endoscopic excision of the mass. An approximately 3-cm-diameter mass was excised by partial turbinectomy, and the posterior edge of the remaining turbinate was cauterized. Conclusion Extranasopharyngeal angiofibromas are rarely seen, and the inferior turbinate is an extremely rare location for them. This young woman is the first case reported in the English literature of angiofibroma originating from the inferior turbinate. We should consider these neoplasms can be found in female, nonadolescent patients with extranasopharyngeal localization, and we should not perform biopsy because of its massive bleeding. .

Histopathologic Diagnosis Associated with Delayed Diagnosis of Inferior Turbinate Pathology / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Conditions of inferior turbinate other than hypertrophy are rare and its morphology of inferior turbinate is variable. Therefore, the diagnosis of this fatal disease is often delayed. In the present study, histopathologic characteristics of inferior turbinate lesions associated with delayed diagnosis are determined by reviewing the clinical and diagnostic outcomes in patients with inferior turbinate lesions. MATERIALS AND METHOD: The medical records of patients who underwent endoscopic inferior turbinate biopsy following histopathologic evaluation from 2002 to 2013 were retrospectively reviewed, including the previous medical history, physical examination, radiologic findings, histopathologic results, therapy, and follow-up examination. RESULTS: A total 21 patients were included. The most common primary symptoms were nasal obstruction and frequent epistaxis. Diagnosed were 9 benign tumors, 7 malignant tumors, 2 infectious lesions, and 3 autoimmune lesions. Six of 21 patients visited more than three different hospitals before visiting our hospital. One-third of the cases with delayed diagnosis were malignant tumors, which included mucosal melanoma and natural killer/T cell lymphoma. CONCLUSION: In patients with nasal obstruction unresponsive to multiple therapeutic attempts, inferior turbinate neoplasia should be suspected to avoid delaying diagnosis and proper treatment.

A Case of Undifferentiated Carcinoma Originating from the Inferior Turbinate of Nasal Cavity / 대한이비인후과학회지

Sinonasal undifferentiated carcinoma (SNUC) is a rare and highly aggressive malignant tumor arising from the schneiderian epithelium of the nasal cavity or paranasal sinuses. The presenting symptoms are diverse depending on the site involved and extent of tumor spread. The treatment of SNUC has evolved to improve overall survival rate and include disease-free control with complete surgical resection including radiotherapy and chemotherapy, but the prognosis still remains dismal. We present a patient with several months of history of intermittent nasal bleeding and stuffiness, which proved to be a rare malignant tumor of inferior turbinate origin, diagnosed as undifferentiated carcinoma of early stage in the disease process. The mass was excised en bloc with endoscopic surgical treatment from inferior turbinate without any additional combined treatment and there was no recurrence during the two-year follow-up period. We report herein, with a review of the literature, an undifferentiated carcinoma arising from the inferior turbinate, which was successfully treated by surgical resection only.

A Case of Angioleiomyoma Arising from the Right Inferior Turbinate / 대한이비인후과학회지

Leiomyoma is a benign smooth muscle neoplasm that rarely becomes malignant. It can occur in any organ of the human body that contains smooth muscles, but the most common forms occur in female genitourinary organs, including the uterus, gastrointestinal organs, including the small bowel and the esophagus and the skin. It rarely occurs in the head and neck area, including the sinonasal cavity. When it occurs in the nasal cavity, its clinical symptoms include nasal obstruction, nasal discharge, nasal bleeding, and pain. We describe herein a case of a 55-year-old man with a leiomyoma in his right inferior nasal turbinate. Transnasal endoscopic excision and paranasal sinus CT were performed. A soft tissue mass on the right inferior turbinate was confirmed from the paranasal sinus CT, and the pathological results revealed a vascular leiomyoma.

Extranasopharyngeal Angiofibroma Originating in the Inferior Turbinate: A Distinct Clinical Entity at an Unusual Site

Introduction: The extranasopharyngeal angiofibroma is histologically similar to juvenile nasopharyngeal angiofibroma, differing from the latterin clinical and epidemiologic characteristics. Objectives We present a case of extranasopharyngeal angiofibroma originating in the inferior turbinate. Resumed Report The patient was a girl, 8 years and 6 months of age, who had constant bilateral nasal obstruction and recurrent epistaxis for 6 months, worse on the right side, with hyposmia and snoring. Nasal endoscopy showed a reddish lesion, smooth, friable, and nonulcerated. Computed tomography showed a lesion with soft tissue density in the right nasal cavity. We used an endoscopic approach and found the lesion inserted in the right inferior turbinate. We did a subperiosteal dissection and excision with a partial turbinectomy with a resection margin of 0.5 cm. Histopathology reported it to be an extranasopharyngeal angiofibroma. Conclusion Although rare, extranasopharyngeal angiofibroma should be considered in the diagnosis of vascular tumors of the head and neck...

Coblation Turbinate Reduction in Patient with Nasal Obstruction / 대한이비인후과학회지

Chronic nasal obstruction is a common symptom and usually comes from mucosal disease associated with turbinate hypertrophy. Diverse surgical treatments have been used to improve chronic nasal obstruction in patients with inferior turbinate hypertrophy. However, there is no common consensus about the values of the various methods. The ideal turbinate surgery should effectively decrease the volume of turbinate, keep physiologic function of nose, and avoid complications. Recently, office-based inferior turbinate reduction using radiofrequency energy has been gaining popularity. In this article, the efficacy and morbidity of coblation turbinate reduction for nasal obstruction will be reviewed.

Clinical research of endoscopic inferior turbinate fracture relocation press in treatment of chronic hypertrophic rhinitis / 中国基层医药

Objective To explore the clinical efficacy of intranasal endoscopic turbinate fracture relocation press in treatment of chronic hypertrophic rhinitis.Methods According to digital table,66 patients with chronic hypertrophic rhinitis were randomly divided into two groups.33 cases in the observation group were treated with endoscopic sinus lateral fracture crush,33 patients in the control group received inferior turbinate submucosal injection of sclerosing treatment.The clinical effect was compared between the two groups.Results The total effective rate of the observation group was 93.9％,which was significantly higher than 72.7％ of the control group (x2 =6.23,P ＜0.05).The average nasal recovery time was (35 ± 12)d in the observation group,which was significantly shorter than (64 ± 21) d in the control group (t =1.74,P ＜ 0.05).The SCT test results had statistically significant differences between the two groups before treatment and 3 months after treatment (t =3.21,2.85,all P ＜0.05).After treatment,the difference was statistically significant between the two groups (t =2.13,P ＜ 0.05).Conclusion Endoscopic turbinate fracture relocation squeezing surgery in the treatment of chronic hypertrophic rhinitis was satisfied.

A Case of Extranasopharyngeal Angiofibroma Arising from the Inferior Turbinate Removed without Pre-Operative Embolization

The angiofibroma is a highly vascular and histologically benign neoplasm that usually arises in the nasopharyx in adolescent male patients. It accounts for less than 0.5% of all head and neck neoplasm. Reports of primary extra-nasopharyngeal angiofibroma have appeared sporadically in the literature. The inferior turbinate is a very rare site of extra-nasopharyngeal angiofibroma, with only 5 cases reported in the medical literature. Also, the value of embolization in surgery for extra-nasopharyngeal angiofibroma is a controversial matter. We report a case of extra-nasopharyngeal angiofibroma arising from the inferior turbinate of a 37-year-old male. The tumor was completely removed through endonasal, endoscopic technique without pre-operative embolization. Histopathology confirmed it to be a case of angiofibroma. The patient is currently free of relapse 6 months after surgery. Endoscopic resection is a feasible and safe method for angiofibroma surgery. The current evidence does not support obligatory embolization in every case of endoscopic angiofibroma resection.

A Case of Extranasopharyngeal Angiofibroma Arising from the Inferior Turbinate Removed without Pre-Operative Embolization

The angiofibroma is a highly vascular and histologically benign neoplasm that usually arises in the nasopharyx in adolescent male patients. It accounts for less than 0.5% of all head and neck neoplasm. Reports of primary extra-nasopharyngeal angiofibroma have appeared sporadically in the literature. The inferior turbinate is a very rare site of extra-nasopharyngeal angiofibroma, with only 5 cases reported in the medical literature. Also, the value of embolization in surgery for extra-nasopharyngeal angiofibroma is a controversial matter. We report a case of extra-nasopharyngeal angiofibroma arising from the inferior turbinate of a 37-year-old male. The tumor was completely removed through endonasal, endoscopic technique without pre-operative embolization. Histopathology confirmed it to be a case of angiofibroma. The patient is currently free of relapse 6 months after surgery. Endoscopic resection is a feasible and safe method for angiofibroma surgery. The current evidence does not support obligatory embolization in every case of endoscopic angiofibroma resection.

Septoplasty and Turbinoplasty ; Current Concept and Technique

Septoplasty is one of the most commonly performed operations in otolaryngology. It is considered extremely valuable in addressing multiple issues and patient complaints. Inferior turbinate surgery results in favorable outcomes and continues to be recommended as a treatment for turbinate hypertrophy not responsive to medical therapy. There are many operative methods used for turbinate surgery such as partial or total turbinectomy and submucosal resection. Laser-assisted conchotomy and Coblation-assisted partial turbinoplasty are minimally invasive procedures that have recently become common. This study provides a comprehensive review of septoplasty and inferior turbinate surgery including current concepts, historical background, classification, updated surgical techniques, and management of complications.

Atypical Angiofibroma Originating from the Inferior Turbinate / 대한이비인후과학회지

Angiofibromas arise from soft tissue, but occur rarely in the nasal cavity. Of these, only six cases have risen from inferior turbinate. Six such cases have been reported previously in English literature and only 1 case in Korea. We present an atypical case of an angiofibroma arising from the inferior turbinate in a 57-year-old woman. The mass was removed with endoscopic approach without massive bleeding.