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Concha bullosa. A radiological study and a new classification.

Christian Calvo-Henríquez1, Xenia Mota-Rojas1, Alberto Ruano-Ravina2

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Summary

Concha bullosa, a pneumatized middle turbinate, is not linked to chronic rhinosinusitis. A new classification based on axial extension aids surgical planning for rare posterior variations.

Keywords:
Concha bullosaCornete medioCornete medio bullosoEthmoid sinusMiddle TurbinateParanasal SinusesSeno etmoidalSenos paranasales

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Area of Science:

  • Otolaryngology
  • Anatomy
  • Radiology

Background:

  • Concha bullosa (CB) is an anatomical variation of the middle turbinate.
  • Existing classifications focus on coronal plane extension.
  • A novel classification based on axial pneumatization is proposed.

Purpose of the Study:

  • To introduce and validate a new classification system for concha bullosa based on axial pneumatization.
  • To assess the prevalence of different concha bullosa types.
  • To investigate the association between concha bullosa and chronic rhinosinusitis.

Main Methods:

  • Retrospective analysis of 196 CT sinonasal scans.
  • Classification of bulbous concha bullosa into six types based on axial plane pneumatization.
  • Comparison of concha bullosa prevalence in patients with and without chronic rhinosinusitis.

Main Results:

  • Concha bullosa was present in 28.06% of patients (13.26% unilateral, 14.79% bilateral).
  • Type I was the most common concha bullosa, followed by types III, II, IV, and V.
  • No statistically significant difference in concha bullosa prevalence was found between patients with or without chronic rhinosinusitis.

Conclusions:

  • Concha bullosa is not associated with chronic rhinosinusitis.
  • Types IV and V represent rare posterior middle turbinate aeration, potentially missed during surgery.
  • The proposed axial classification serves as a valuable preoperative surgical reference.