Clinical Aspect of Concha Bullosa of Middle Turbinate and Nasal Septal Deviation

Objectives: Concha bullosa (CB) with nasal septal deviation (NSD) can be the cause of postoperative functional failure if not corrected during surgery. Methods: All the paranasal computed tomography scans (CTs) taken in a tertiary hospital from May 2011 to October 2012 were analyzed. Cases with history of nasal surgery and nasal trauma were excluded due to the possibilities of nasal anatomical changes. Results: 520 CTs were included in this study, from 550 CTs analyzed. 331 males and 189 females were included, and the ages of patients ranged from 2 to 87. 444 patients (85.38%) had NSD. The age distributions of CB were as follows: in the age group of 0~15, 0%; 16~30,.70%; 31~45, 40%; 46~60, 33.14%; and over 60 years, 25%. In 444 patients with NSD, bilateral CBs were observed in 93, unilateral CBs in wide nasal cavity in 47, and narrow nasal cavity in 7. When 269 CBs were classified as true, lamella, or bullous type, the average measured pneumatization areas were statistically wider in true type (p=0.008). When comparing the maximum pneumatization areas of CB in coronal CT of patients with NSD, the CB area of wide side nasal cavity was statistically wider than that of narrow side nasal cavity (P = 0.000). Conclusions: CBs are clinically thought to be formed in those over 15 years old. CBs are formed mainly in wider nasal cavity, and especially larger in true type, so they should be removedin surgery.