A concha bullosa is when a nasal turbinate becomes pneumatized, or filled with air. Most people have three separate turbinates on each side of the nose. A concha bullosa most commonly occurs in the middle turbinate.
The majority of the time, a concha bullosa is a normal anatomic variant that does not cause symptoms. However, depending on the size and location, a concha bullosa may lead to symptoms such as sinus infections or trouble breathing through the nose. This can occur if the concha bullosa blocks the sinus drainage pathway, known as the ostiomeatal complex. Furthermore, a concha bullosa can cause airway obstruction. This occurs if it takes up too much space in the nose. Alternatively, the concha bullosa can push and deviate the septum, effectively narrowing the contralateral nasal cavity.
For patients with symptomatic findings of a concha bullosa that have failed medical therapy, surgery may be warranted. A concha bullosa can be crushed to squeeze out the air, can be partially reduced, or completely resected. My general preference is to partially reduce the size of the concha bullosa by resecting the lateral portion only. I avoid completely resecting the turbinate. This approach has great long-term results, while minimizing the likelihood of nasal dryness or empty nose syndrome. In some cases, crushing the concha bullosa may be effective, though this may result in a higher recurrence rate.
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