The incidence of concha bullosa and the correlation with nasal septal deviation.

OBJECTIVES: To analyse the incidence of concha bullosa and any aetiological correlation with nasal septal deviation. METHODOLOGY: Paranasal sinus computerised tomography (CT) scans were made of 143 consecutive patients with sinonasal symptoms. Patients with altered anatomy (iatrogenic or pathological) were excluded and the remaining CT scans were analysed for the pneumatisation of the middle turbinate, septal deviation and the correlation between them. RESULTS: Sixty-three percent of patients had some types of septal deviation and 35% had unilateral or bilateral concha bullosa. Septal deviation was present in 9 out of 13 patients (69.2%) with large unilateral or dominant concha bullosa, 10 out of 24 (41.7%) with medium unilateral or dominant concha bullosa, and 12 out of 30 (40%) with small concha bullosa. There was a clear link between the presence of a unilateral concha, or a dominant concha (in bilateral concha), and the presence of nasal septal deviation (P <0.009). CONCLUSIONS: After the assessment of various sizes and shape of concha bullosa and the form of nasal septal deviation away from the dominant concha, we suggest that deviation is an indirect result of the presence of the concha. This hypothesis can be proved by reference to the laws of physics.