The relationship among concha bullosa, septal deviation and chronic rhinosinusitis

Abstract:

Objective: To evaluate the prevalence and types of both concha bullosa and nasal septal deviation and determine their potential relationships with maxillary rhinosinusitis.

Methods: Patients admitted to the outpatient clinic of the otorhinolaryngology department with symptoms of rhinosinusitis between January 2009 and April 2010, were retrospectively enrolled in the study. Paranasal sinus computed tomography scans were reviewed for the presence, side and type of concha bullosa, and nasal septal deviation along with rhinosinusitis.

Results: Totally 162 patients (324 sides) were studied. Concha bullosa and nasal septal deviation incidences were 42.6% and 46.9%, respectively. The relationship between nasal septal deviation and the presence of concha bullosa was not statistically significant (p=0.06). A total of 45.1% of patients had evidence of maxillary rhinosinusitis. The involvement of the other sinuses was frontal in 28 (17.3%), ethmoid in 48 (29.6%) and sphenoid in 26 (16%) patients. When the location of sinus involvement was taken into consideration, the maxillary rhinosinusitis was more frequently involved in cases with concha bullosa (p=0.04). There was a relationship between right concha bullosa (p=0.013), left concha bullosa (p=0.034), presence of reverse curvature (p=0.043), obliteration of osteomeatal complex (p=0.0008) and rhinosinusitis. There was a relationship between the degree and type of concha bullosa and rhinosinusitis (p=0.030). Rhinosinusitis was detected more frequently (55.5%) in cases with extensive type concha bullosa.

Conclusion: Concha bullosa is a frequently encountered variation and leads to susceptibility to rhinosinusitis. For this reason, preoperative and premedicative computed tomography scan is important for the sinus, especially extensive type concha bullosa.