AN EXTENDED STUDY ON CONCHA BULLOSA SUBTYPES

Abstract

To determine the concha bullosa subtypes and their possible associations with chronic sinusitis, osteomeatal complex obstruction, mucosal thickening and other sinonasal anatomic variations, in a large group of patients with concha bullosa. This retrospective study was conducted between January 2019 and March 2020 in two different institutions. The paranasal CT sections and medical records of 850 patients (1700 sides) were evaluated, and the association of concha bullosa subtypes with other sinonasal variations like chronic sinusitis, osteometal complex obstruction and mucosal thickening was investigated. Concha bullosa was observed in 430 (25.2%) of 1700 sides. Of 430 bullous conchas, 160 were bilateral (37%), 245 were on the right (56.9%), 185 were on the left (43.1%). Extensive type in 202 sides, bulbous type in 118 sides and lamellar type in 100 sides were observed. A significant association of extensive type concha bullosa with chronic sinusitis (p: 0.025), osteometal complex obstruction (p: 0.043) and septum deviation was found (p: 0.013). Additionally, a significant association of lamellar type concha bullosa with female gender (p: 0.021) and of bulbous type concha bullosa with osteomeatal complex obstruction (p: 0.038) was evident. The most frequent anatomical variation was septal deviation, found in (73.1%) 256 of 350 patients with concha bullosa. The frequency of chronic sinusitis, osteomeatal complex obstruction and septal deviation were significantly higher in extensive type concha bullosa than in the other subtypes. Familiarity of surgeons and radiologists with concha bullosa subtypes might be important for determining the treatment algorithm during endoscopic sinus surgery.