Role of Surgery in Isolated Concha Bullosa

Abstract

Objective:To study the benefit of surgery in different types of isolated concha bullosa.Design:Prospective case series.Setting:Academic Medical Center.Patients:Forty seven symptomatic patients complaining of nasal congestion and block, headache and facial pain having concha bullosa without any other sinonasal finding. Their conchae bullosa were classified as lamellar, bulbous and extensive concha bullosa. They were subjected to endoscopic operation.Main outcome measures:Subjective evaluation of postoperative improvement of sinonasal symptoms and objective pre- and postoperative measurement of total nasal resistance by rhinomanometry.Results:Two patients (25%) of lamellar type showed complete improvement, 5 patients (62.5%) showed partial improvement and 1 patient (12.5%) showed no improvement. Regarding bulbous type, 16 patients (72.72%) showed complete improvement, 6 patients (27.28%) showed partial improvement and no patient (0%) showed no improvement. Regarding extensive type, 15 (88.24%) patients showed complete improvement, 2 patients (11.76%) showed partial improvement and no patient (0%) showed no improvement. The total nasal resistance was 0.25 Pa/cm3 per second postoperatively compared with 0.37 Pa/cm3 per second preoperatively in patients having lamellar type; 0.28 Pa/cm3 per second postoperatively compared with 0.71 Pa/cm3 per second preoperatively in patients having bulbous type; and 0.27 Pa/cm3 per second postoperatively compared with 0.67 Pa/cm3 per second preoperatively in patients having extensive type.Conclusions:With proper patient selection, the operative management is of great value in relieving the sinonasal symptoms in patients having isolated Concha bullosa. This will be more obvious in certain types as bulbous and extensive types especially of large sizes.

Mucosal contact points and paranasal sinus pneumatization: Does radiology predict headache causality?

“…One of the most common anatomical sinonasal variations is middle turbinate concha bullosa, which can be small or large, unilateral or bilateral, and unichambered or multichambered . Concha bullosa has been thought to cause headache or facial pain even in the absence of mucosal contact . However, our results, as well as those in other studies, showed no significant relationship between concha bullosa and headache …”

“…3 Concha bullosa has been thought to cause headache or facial pain even in the absence of mucosal contact. [50][51][52] However, our results, as well as those in other studies, showed no significant relationship between concha bullosa and headache. 43 Certain types of excessive pneumatization of PNSs are thought to cause headaches.…”

Eustachian dysfunction in chronic otitis media with bilateral concha bullosa: Is it chance finding?

“…This has been supported by significant statistical correlation that has been observed between the results of tubal manometric measurements for Eustachian dysfunction and increased nasal resistance by rhinomanometric and constant body plethysmography (Jaeger), respectively, in two separate studies. [5,6] Different techniques for turbinoplasty include endoscopic partial lateral middle turbinectomy [7] and evacuation conchoplasty [8] for surgical management of concha bullosa. We used the latter technique in our patient.…”

A Comparative Evaluation Between Ct Scan PNS WTH Nasal Endoscopy Findings in Patients of Chronic Rhinosinusitis

“…Badran et al 2011 36 studied 47 patient sinuses CT scan showing pneumatisation of middle turbinate and found 17% cases of lamellar, 46.8% cases of bullous and 36.2% cases of extensive concha bullosa.…”