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Middle turbinate absence is reported as a rare anatomical variation of the lateral nasal wall. We found a bilateral partial absence with the conchal plate still present. The origin of this variation is unknown; three hypothesis are: agenesis of the middle turbinate, chronic use of topical vasoconstrictor, or cocaine-induced atrophy. Surgical origin is excluded by absence of signs of surgery and by bilaterality of the variation. These observations could help to better understand the complex anatomy of frontal recess and its subunits, such as suprainfundibular plate, frontal sinus drainage pathway, vertical part of uncinate process, bulla ethmoidalis and so on.