The Impact of Unilateral Concha Bullosa on Mucociliary Activity: An Assessment by Rhinoscintigraphy

BACKGROUND: In this study, we aimed to compare the differences of nasal mucociliary clearance rate (NMCR) by rhinoscintigraphic examination between the nasal cavities of patients with unilateral concha bullosa (CB). METHODS: The study group consisted of 43 patients (18 men and 25 women), with unilateral CB ranging in age from 20 to 58 years (mean age, 33.5 ± 9.51 years). The nasal mucociliary clearance was described as the velocity (mm/min) of nasal mucociliary transport of the technetium 99m-macroaggragated albumin droplet. Rhinoscintigraphy was performed on each nasal cavity with 2-day intervals in the patients. The mucociliary clearance rates obtained in the unaffected side were accepted as control values. RESULTS: The average values for mucociliary clearance rate were 2.29 ± 0.42 mm/min in the CB side of the nasal cavity, and 3.19 ± 0.52 mm/min in the other side of the nasal cavity. Mucociliary transport took a longer time in the CB side of the nasal cavity than in the other side of the nasal cavity, which was found to be statistically significant (p < 0.001). CONCLUSION: Our study showed that unilateral CB might impair NMCR in the ipsilateral side of the nasal cavity. Thus surgical intervention to reduce the middle concha volume may result in a better mucociliary clearance with possibly a less chance of development of chronic sinus diseases and nasal pathologies. Obviously, it is of utmost importance that new studies be planned with larger patient series to better understand nasal mucociliary transport mechanism and CB relationships.