Nasal Obstruction due to Fibrous Dysplasia Invading Inferior and Middle Turbinates: A Case Report and Literature Review

Fibrous dysplasia (FD) is a rare type of fibro-osseous lesion characterized by fibroblastic proliferation and progressive substitution of the normal bone with fibrotic disorganized bony trabeculae. Although several etiological theories, such as neoplastic degeneration and genetic or embryologic modification, have been proposed, the exact pathogenesis of FD is still unknown. 70% of all FD cases are of the monostotic form, and only 10% of these involve the craniofacial bones. 30% of all FD cases are of the polyostotic form, and more than 50% of these involve the craniofacial bones. The polyostotic form may be associated with McCune-Albright syndrome, which is the most severe form of polyostotic FD. As FD has a tendency to affect membranous bones such as the femur or tibia, involvement of the sinonasal cavity is rare, and involvement of the inferior and/or middle turbinate bones is extremely rare. In this report, we describe a case of severe FD involving the right inferior and middle turbinates and the almost-complete obstruction of the right nasal cavity. We also review previously-reported cases of FD-induced nasal obstruction symptoms with inferior and/or middle turbinate involvement.