| Summary: | We present a patient with intractable frontal headache and intranasal polyposis, who was found to have a massive, complex osteoma arising within a concha bullosa. A 23 year old male presented with severe symptoms poorly responsible to medical management with rapidly progressive, associated with diplopia and imbalance. The scan revealed a very large osteoma (59.81 mm × 33.38 mm x 32.00 mm) arising within a right-sided concha bullosa of the middle turbinate and extending into the nasopharynx was shown in CT scan. The patient underwent an urgent image-guided modified endoscopic Lothrop's procedure to facilitate complete endoscopic excision thorough sinus drainage. To date, there are only 8 case reports of osteoma of the middle turbinate. We are, presenting the case where the osteoma of an aerated middle turbinate was of such a massive size. This case highlights the importance of giving common symptoms, such as headache, the required attention and consideration before dismissing them as trivial.
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