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Concha Bullosa
Axel Ruprecht, DDS, MScD, FRCD(C)
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Concha pneumatization
            • Turbinate pneumatization
          • Definitions

            • Extension of sinus into concha
            • Invagination into double lamella of inferior concha during development
            • Pneumatization of 50% or more of vertical height of middle concha

          IMAGING

          • General Features

            • CT Findings

              • Imaging Recommendations

                CLINICAL ISSUES

                • Presentation

                  • Natural History & Prognosis

                    • Treatment

                      DIAGNOSTIC CHECKLIST

                      • Consider

                        • Image Interpretation Pearls

                          • Reporting Tips

                            Selected References

                            1. Gungor S et al: Infected concha bullosa mimicking a malignant lesion on 18F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol. 35(4):270-1, 2016
                            2. Loftus PA et al: Anatomic variants of the paranasal sinuses in patients with recurrent acute rhinosinusitis. Int Forum Allergy Rhinol. 6(3):328-33, 2016
                            3. Min HJ et al: The potential significance of concha bullosa during nasotracheal intubation. J Craniofac Surg. 27(2):e153-4, 2016
                            4. Rusu MC et al: The pterygopalatine recess of the superior nasal meatus. Surg Radiol Anat. 38(8):979-82, 2016
                            5. Shin JM et al: Analysis of sinonasal anatomical variations associated with maxillary sinus fungal balls. Auris Nasus Larynx. 43(5): 524-8, 2016
                            6. Tomblinson CM et al: The impact of middle turbinate concha bullosa on the severity of inferior turbinate hypertrophy in patients with a deviated nasal septum. AJNR Am J Neuroradiol. 43(5):524-8, 2016
                            7. Angulo-Pérez G et al: [Prevalence, location and tomographic severity of chronic rhinosinusitis in adult patients with common variable immunodeficiency.] Rev Alerg Mex. 62(1):15-21, 2015
                            8. Bandyopadhyay R et al: Osteomeatal complex: a study of its anatomical variation among patients attending north bengal medical college and hospital. Indian J Otolaryngol Head Neck Surg. 67(3):281-6, 2015
                            9. Cantone E et al: Concha bullosa related headache disability. Eur Rev Med Pharmacol Sci. 19(13):2327-30, 2015
                            10. Demir UL et al: Anatomical correlation between existence of concha bullosa and maxillary sinus volume. Surg Radiol Anat. 37(9):1093-8, 2015
                            11. Göçmen G et al: Effect of septal deviation, concha bullosa and Haller's cell on maxillary sinus's inferior pneumatization; a retrospective study. Open Dent J. 9:282-6, 2015
                            12. Khojastepour L et al: Anatomical variations of ostiomeatal complex in CBCT of patients seeking rhinoplasty. J Dent (Shiraz). 16(1):42-8, 2015
                            13. Lee JH et al: Underestimation of rhinogenic causes in patients presenting to the emergency department with acute headache. Acta Neurol Taiwan. 24(2):37-42, 2015
                            14. Măru N et al: Variant anatomy of nasal turbinates: supreme, superior and middle conchae bullosae, paradoxical superior and inferior turbinates, and middle accessory turbinate. Rom J Morphol Embryol. 56(3):1223-6, 2015
                            15. Selcuk OT et al: Do altitude and climate affect paranasal sinus volume? J Craniomaxillofac Surg. 43(7):1059-64, 2015
                            16. Tiwari R et al: Study of anatomical variations on CT in chronic sinusitis. Indian J Otolaryngol Head Neck Surg. 67(1):18-20, 2015
                            17. Worrall DM et al: Concha bullosa: a shield against allergens? ORL J Otorhinolaryngol Relat Spec. 77(5):281-6, 2015
                            18. Berjis N et al: Some anatomical variation of paranasal sinuses using sinus endoscopic approach on "cadaver" in Isfahan, Iran. Adv Biomed Res. 3:51, 2014
                            19. Javadrashid R et al: Concha bullosa, nasal septal deviation and paranasal sinusitis; a computed tomographic evaluation. B-ENT. 10(4):291-8, 2014
                            20. San T et al: Bilateral superior concha bullosa: a rare case overlooked. Kulak Burun Bogaz Ihtis Derg. 24(5):292-4, 2014
                            21. San T et al: Bilateral triple concha bullosa: a very rare anatomical variation of intranasal turbinates. Case Rep Otolaryngol. 2014:851508, 2014
                            22. Jain R et al: Comparison of anatomical abnormalities in patients with limited and diffuse chronic rhinosinusitis. Int Forum Allergy Rhinol. 3(6):493-6, 2013
                            23. Ozturan O et al: Pneumo-concha dilatans: middle concha growing in anterior and lateral directions. J Craniofac Surg. 24(4):e444-6, 2013
                            24. Ozturan O et al: 'Conchae bullosis': a rare case with bilateral triple turbinate pneumatisations. J Laryngol Otol. 127(1):73-5, 2013
                            25. Pittore B et al: Concha bullosa of the inferior turbinate: an unusual cause of nasal obstruction. Acta Otorhinolaryngol Ital. 31(1):47-9, 2011
                            26. Homsioglou E et al: Pneumatized superior turbinate as a cause of headache. Head Face Med. 3:3, 2007
                            27. Kiroglu AF et al: Isolated turbinitis and pneumatization of the concha inferior in a child. Am J Otolaryngol. 28(1):67-8, 2007
                            28. Erkan AN et al: Polyp in concha bullosa: a case report and review of the literature. Head Face Med. 2:11, 2006
                            29. Hatipoğlu HG et al: Concha bullosa types: their relationship with sinusitis, ostiomeatal and frontal recess disease. Diagn Interv Radiol. 11(3):145-9, 2005
                            30. Alper F et al: A massive superior concha bullosa: case report and literature review. Rhinology. 42(1):38-40, 2004
                            31. Stallman JS et al: The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. AJNR Am J Neuroradiol. 25(9):1613-8, 2004
                            32. Yanagisawa E et al: An unusual lateral ostium of a concha bullosa of the middle turbinate. Ear Nose Throat J. 82(3):159-60, 2003
                            33. Maru YK et al: Concha bullosa: Frequency and appearances on sinonasal CT. Indian J Otolaryngol Head Neck Surg. 52(1):40-4, 1999
                            34. Clerico DM: Pneumatized superior turbinate as a cause of referred migraine headache. Laryngoscope. 106(7):874-9, 1996
                            35. Cukurova I, et al A patient presenting with concha bullosa in another concha bullosa: a case report. J Med Case Reports 6: 87,2012
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                • Clinical Issues

                                  • Diagnostic Checklist

                                    TERMINOLOGY

                                    • Synonyms

                                      • Concha pneumatization
                                      • Turbinate pneumatization
                                    • Definitions

                                      • Extension of sinus into concha
                                      • Invagination into double lamella of inferior concha during development
                                      • Pneumatization of 50% or more of vertical height of middle concha

                                    IMAGING

                                    • General Features

                                      • CT Findings

                                        • Imaging Recommendations

                                          CLINICAL ISSUES

                                          • Presentation

                                            • Natural History & Prognosis

                                              • Treatment

                                                DIAGNOSTIC CHECKLIST

                                                • Consider

                                                  • Image Interpretation Pearls

                                                    • Reporting Tips

                                                      Selected References

                                                      1. Gungor S et al: Infected concha bullosa mimicking a malignant lesion on 18F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol. 35(4):270-1, 2016
                                                      2. Loftus PA et al: Anatomic variants of the paranasal sinuses in patients with recurrent acute rhinosinusitis. Int Forum Allergy Rhinol. 6(3):328-33, 2016
                                                      3. Min HJ et al: The potential significance of concha bullosa during nasotracheal intubation. J Craniofac Surg. 27(2):e153-4, 2016
                                                      4. Rusu MC et al: The pterygopalatine recess of the superior nasal meatus. Surg Radiol Anat. 38(8):979-82, 2016
                                                      5. Shin JM et al: Analysis of sinonasal anatomical variations associated with maxillary sinus fungal balls. Auris Nasus Larynx. 43(5): 524-8, 2016
                                                      6. Tomblinson CM et al: The impact of middle turbinate concha bullosa on the severity of inferior turbinate hypertrophy in patients with a deviated nasal septum. AJNR Am J Neuroradiol. 43(5):524-8, 2016
                                                      7. Angulo-Pérez G et al: [Prevalence, location and tomographic severity of chronic rhinosinusitis in adult patients with common variable immunodeficiency.] Rev Alerg Mex. 62(1):15-21, 2015
                                                      8. Bandyopadhyay R et al: Osteomeatal complex: a study of its anatomical variation among patients attending north bengal medical college and hospital. Indian J Otolaryngol Head Neck Surg. 67(3):281-6, 2015
                                                      9. Cantone E et al: Concha bullosa related headache disability. Eur Rev Med Pharmacol Sci. 19(13):2327-30, 2015
                                                      10. Demir UL et al: Anatomical correlation between existence of concha bullosa and maxillary sinus volume. Surg Radiol Anat. 37(9):1093-8, 2015
                                                      11. Göçmen G et al: Effect of septal deviation, concha bullosa and Haller's cell on maxillary sinus's inferior pneumatization; a retrospective study. Open Dent J. 9:282-6, 2015
                                                      12. Khojastepour L et al: Anatomical variations of ostiomeatal complex in CBCT of patients seeking rhinoplasty. J Dent (Shiraz). 16(1):42-8, 2015
                                                      13. Lee JH et al: Underestimation of rhinogenic causes in patients presenting to the emergency department with acute headache. Acta Neurol Taiwan. 24(2):37-42, 2015
                                                      14. Măru N et al: Variant anatomy of nasal turbinates: supreme, superior and middle conchae bullosae, paradoxical superior and inferior turbinates, and middle accessory turbinate. Rom J Morphol Embryol. 56(3):1223-6, 2015
                                                      15. Selcuk OT et al: Do altitude and climate affect paranasal sinus volume? J Craniomaxillofac Surg. 43(7):1059-64, 2015
                                                      16. Tiwari R et al: Study of anatomical variations on CT in chronic sinusitis. Indian J Otolaryngol Head Neck Surg. 67(1):18-20, 2015
                                                      17. Worrall DM et al: Concha bullosa: a shield against allergens? ORL J Otorhinolaryngol Relat Spec. 77(5):281-6, 2015
                                                      18. Berjis N et al: Some anatomical variation of paranasal sinuses using sinus endoscopic approach on "cadaver" in Isfahan, Iran. Adv Biomed Res. 3:51, 2014
                                                      19. Javadrashid R et al: Concha bullosa, nasal septal deviation and paranasal sinusitis; a computed tomographic evaluation. B-ENT. 10(4):291-8, 2014
                                                      20. San T et al: Bilateral superior concha bullosa: a rare case overlooked. Kulak Burun Bogaz Ihtis Derg. 24(5):292-4, 2014
                                                      21. San T et al: Bilateral triple concha bullosa: a very rare anatomical variation of intranasal turbinates. Case Rep Otolaryngol. 2014:851508, 2014
                                                      22. Jain R et al: Comparison of anatomical abnormalities in patients with limited and diffuse chronic rhinosinusitis. Int Forum Allergy Rhinol. 3(6):493-6, 2013
                                                      23. Ozturan O et al: Pneumo-concha dilatans: middle concha growing in anterior and lateral directions. J Craniofac Surg. 24(4):e444-6, 2013
                                                      24. Ozturan O et al: 'Conchae bullosis': a rare case with bilateral triple turbinate pneumatisations. J Laryngol Otol. 127(1):73-5, 2013
                                                      25. Pittore B et al: Concha bullosa of the inferior turbinate: an unusual cause of nasal obstruction. Acta Otorhinolaryngol Ital. 31(1):47-9, 2011
                                                      26. Homsioglou E et al: Pneumatized superior turbinate as a cause of headache. Head Face Med. 3:3, 2007
                                                      27. Kiroglu AF et al: Isolated turbinitis and pneumatization of the concha inferior in a child. Am J Otolaryngol. 28(1):67-8, 2007
                                                      28. Erkan AN et al: Polyp in concha bullosa: a case report and review of the literature. Head Face Med. 2:11, 2006
                                                      29. Hatipoğlu HG et al: Concha bullosa types: their relationship with sinusitis, ostiomeatal and frontal recess disease. Diagn Interv Radiol. 11(3):145-9, 2005
                                                      30. Alper F et al: A massive superior concha bullosa: case report and literature review. Rhinology. 42(1):38-40, 2004
                                                      31. Stallman JS et al: The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. AJNR Am J Neuroradiol. 25(9):1613-8, 2004
                                                      32. Yanagisawa E et al: An unusual lateral ostium of a concha bullosa of the middle turbinate. Ear Nose Throat J. 82(3):159-60, 2003
                                                      33. Maru YK et al: Concha bullosa: Frequency and appearances on sinonasal CT. Indian J Otolaryngol Head Neck Surg. 52(1):40-4, 1999
                                                      34. Clerico DM: Pneumatized superior turbinate as a cause of referred migraine headache. Laryngoscope. 106(7):874-9, 1996
                                                      35. Cukurova I, et al A patient presenting with concha bullosa in another concha bullosa: a case report. J Med Case Reports 6: 87,2012