Concha bullosa

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Concha Bullosa is an abnormal pneumatization of the middle turbinate which may interfere with normal ventilation of sinus ostia and can result in recurrent sinusitis.

As explained by doctors, "Concha bullosa refers to an enlargement or ballooning of the nasal turbinate (which is a normal structure in the nose). Concha bullosa is a normal anatomic variant, but occasionally, a concha bullosa can be very large and contribute to sinus obstruction. In these cases, the concha bullosa can be readily reduced by surgery."

Concha refers to the turbinate in this case, the middle turbinate. Bullosa refers to a bubble-like structure. A middle turbinate which has an air cell in it is a concha bullosa. When these are large, they can cause nasal obstruction or facial pressure or blockage of the sinus outflow tracts. They are easily reduced with endoscopic sinus surgery.

Left concha bullosa

Types of Concha Bullosa

Concha bullosa (CB) is the pneumatization of the concha and is one of the most common variations of the sinonasal anatomy. A 14%-53.6% frequency of concha bullosa was reported by various studies (1). Pneumatization of the concha, regardless of the amount and the location, was defined as concha bullosa (2). Bolger et al. have classified pneumatization of the concha based on the location as lamellar concha bullosa (LCB), bulbous concha bullosa (BCB) and extensive concha bullosa (ECB) (3)

Conclusion

Concha bullosa is a common anatomic variant. There is a strong association between the presence of a concha bullosa and contralateral deviation of the nasal septum. Nasal septal deviation away from the dominant concha, with preserved adjacent air channels, suggests that the deviation is not a direct result of mass effect from the concha. No increased incidence of paranasal sinus disease exists in patients with concha bullosa.

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