A bilateral concha bullosa and a left-sided septal deviation were noted, along with an air-fluid level in the left concha bullosa suggesting a mucocele on the left.
The incidence of concha bullosa varies from 14 to 53%.
Like other aerated cells, a concha bullosa possesses a mucociliary transport system, with the ostium connecting the airy cell lumen to the frontal recess.
The characteristics of this very rare case of polyps in bilateral conchae bullosa support the hypotheses that a concha bullosa is actually a pneumatized structure of the paranasal sinus system, and that it is connected to the frontal recess by an ostium.
The most common drainage pathway of a concha bullosa has been described as a single ostium posteriorly into the ethmoid sinus.
Endoscopic view of a powered partial resection of a concha bullosa.
The case described here involved an unusual isolated recurrent infection of a concha bullosa
without involvement of the paranasal sinuses.
A microdebrider was passed into the anterior face of the middle turbinate to open the concha bullosa (figure, B); this procedure is similar to that used to enter the ethmoid bulla during powered endoscopic sinus surgery.
Light pressure can be applied to the anterior surface of the concha bullosa, and the portion to be removed can be shaved away with minimal trauma to the remaining middle turbinate and surrounding structures.
Concha bullosa is the result of a pneumatization of the anterior half of the middle turbinate.
Concha bullosa was initially described by Santorini in 1739.
True concha bullosa
occurs as a result of extensive pneumatization of the turbinate.