Clinical Medicine Insights: Ear, Nose and Throat

Objective: To study the benefit of surgery in different types of isolated concha bullosa.

Design: Prospective case series.

Setting: Academic Medical Center.

Patients: Forty seven symptomatic patients complaining of nasal congestion and block, headache and facial pain having concha bullosa without any other sinonasal finding. Their conchae bullosa were classified as lamellar, bulbous and extensive concha bullosa. They were subjected to endoscopic operation.

Main outcome measures: Subjective evaluation of postoperative improvement of sinonasal symptoms and objective pre- and postoperative measurement of total nasal resistance by rhinomanometry.

Results: Two patients (25%) of lamellar type showed complete improvement, 5 patients (62.5%) showed partial improvement and 1 patient (12.5%) showed no improvement. Regarding bulbous type, 16 patients (72.72%) showed complete improvement, 6 patients (27.28%) showed partial improvement and no patient (0%) showed no improvement. Regarding extensive type, 15 (88.24%) patients showed complete improvement, 2 patients (11.76%) showed partial improvement and no patient (0%) showed no improvement. The total nasal resistance was 0.25 Pa/cm3 per second postoperatively compared with 0.37 Pa/cm3 per second preoperatively in patients having lamellar type; 0.28 Pa/cm3 per second postoperatively compared with 0.71 Pa/cm3 per second preoperatively in patients having bulbous type; and 0.27 Pa/cm3 per second postoperatively compared with 0.67 Pa/cm3 per second preoperatively in patients having extensive type.

Conclusions: With proper patient selection, the operative management is of great value in relieving the sinonasal symptoms in patients having isolated Concha bullosa. This will be more obvious in certain types as bulbous and extensive types especially of large sizes.