CONCHA BULLOSA AND ITS ASSOCIATION WITH DNS AND SINUSITIS.

Background and Purpose: The incidence of middle turbinate pneumatization, or concha bullosa, has been well described in the literature. In this study, we sought to analyze the incidence of concha bullosa and any correlation with nasal septal deviation and paranasal sinus disease. Methods: We retrospectively reviewed findings of 140 consecutive paranasal sinus CT studies conducted between January 2016 and December 2016. All examinations were performed for evaluation of a symptom referable to the sinonasal region. Paranasal sinus inflammatory disease was identified and graded as mild, moderate, or severe. If a concha bullosa was present, it was graded in size as small, moderate, or large. If bilateral concha were present, sizes were compared and when one was larger, it was identified as dominant. When nasal septal deviation was present, it was graded as mild, moderate, or severe. The direction of nasal septal deviation was identified as the face of the convex surface. Results: There was a clear association between the presence of a unilateral concha, or a dominant concha (in the case of bilateral concha), and the presence of nasal septal deviation (P = 0.012). In every case, there was some preservation of air channels between the dominant concha and the nasal septum. 71.2% of patients with concha bullosa had paranasal sinus inflammatory disease; 76.54% of patients without concha bullosa also had some form of inflammatory disease. Conclusion: Concha bullosa is a common anatomic variant. There is a strong association between the presence of a concha bullosa and contralateral nasal septum devaition. 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.