Concha Bullosa
Overview
A concha bullosa is a normal sinonasal variant in which a nasal turbinate has been pneumatized, resulting in a "hollow" turbinate.
History
Pathophysiology
Relevant Anatomy
Disease Etiology
Genetics
Histology
Diagnosis
Patient History
Patients should be asked about any history consistent with chronic or recurrent sinonasal issues:
- Nasal obstruction
- Chronic congestion
- Seasonal allergies
- Rhinorrhea
- Epistaxis
- Headaches
- Facial pain
- Facial pressure
- Recurrent sinus infections
- Sinus infections refractory to antibiotics
Physical Examination
A pneumatized turbinate will often have an altered shape or size, which may be apparent on anterior rhinoscopy or nasal endoscopy. The nasal septum will often be deviated away from the side of the concha bullosa (or away from the side of the dominant concha bullosa in the setting of bilateral CB's). There is no consistent or hallmark feature visible on physical exam to definitively diagnose a concha bullosa without imaging.
Imaging
The location and extent of a concha bullosa is often apparent on imaging of the head and neck. This cut (1 mm) CT scan without contrast of the facial bones or sinuses are often optimal for visualization of a concha bullosa.
Differential Diagnosis
While imaging is often diagnostic for a concha bullosa, the following should be considered for patients with atypical nasal turbinate anatomy or size:
- Nasal turbinate hpyertrophy
- Osteoma or other bony lesion within the turbinate