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What is a Concha Bullosa?

By Jessica F. Black
Updated Mar 03, 2024
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Concha bullosa occurs when the middle turbinate, a small bone projection in the nasal cavity, experiences an air pocket. Depending on the severity, concha bullosa may either be accompanied by several symptoms or, in some cases, it can be asymptomatic. Treatment of this condition may vary and is generally based on the discomfort felt by the patient. Most cases are associated with a deviated nasal septum and are usually discovered in a computerized tomography (CT) exam. The three types of concha bullosa are lamellar, bulbous, and extensive, and are not usually considered a medical hazard.

The nasal cavity consists of three turbinates, or fine hairs, that act as a fliter for pollutants, as well as a bone and cartilage divider called the septum. Turbinates work to cool or warm the air inhaled through the nose in order to reach body temperature through humidification. Concha bullosa is a small balloon-like formation on a turbinate and, depending on the size, it may cause trouble with breathing or draining sinuses. It is an open space that is vulnerable to infection and nasal obstruction. This air bubble usually causes the turbinate to enlarge and apply pressure to other nasal components, which may cause pain.

Those who experience symptoms usually feel a pain between the eyes, nasal discomfort, and facial pressure if the concha bullosa is large in size. A CT exam is used after other potential problems are ruled out. Nasal sprays and decongestants may reduce problems associated with concha bullosa but if pain persists, a CT and minor surgery may be necessary.

Endoscopic sinus surgery is used to correct severe cases of concha bullosa, and is a minor surgery which normally takes a few hours. Surgeons use a fiberoptic endoscope to examine and correct dysfunctions of the naval cavity. Patients are sometimes sedated with a local anesthesia and, following the surgery, the corrected area is lightly filled with sterile packing. Post surgery discomfort is usually mild, but inflammation of the area may take a few weeks to subside.

Surgeons may request that the patient refrain from swimming or other activities that may cause an abundance of fluids in the nose, including taking precaution when bathing. The nasal cavity is a sensitive area to have surgery on, and it may produce some post-surgical problems including bleeding, infection, and temporary vision difficulties. Infections and other topical discomfort is usually treated with anti-biotic ointments, oral steroids, and antihistamines.

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Discussion Comments

By anon990930 — On May 16, 2015

@Elaine - I've had a similar experience with an ENT telling me he found nothing and that my sinus headaches might be neurological in nature. Eventually I was talking to someone who also had chronic sinusitis and she strongly recommended her ENT (she said sinus surgery changed her life). That ENT looked at the exact same CT scans and saw infection that the other doctor missed or disregarded! He said that with my history of frequent infections, deviated septum, poor drainage and "hollow" middle turbinates, I was a good candidate for surgery. I'm getting it done next month and I'm excited at the possibility of ending the chronic sinusitis.

I'd strongly recommend finding another ENT for a second opinion. If you can find people in your area who have had good result, all the better.

By amypollick — On Apr 07, 2012

@Elaine: This is one of those situations, I think, where you're just going to have to be your own best advocate. First, get your own copies of all your medical records, test results, X-ray reports, bloodwork, *everything.* Then, find an ENT or other specialist who is accepting new patients and make an appointment.

Make copies of all your records and hand-deliver them to the ENT's office. That way, you'll know they arrived.

When you get to your appointment, have relevant portions of your records in hand and start asking questions.

I don't know where you live, but if there is a medical school/teaching hospital in your area, go see one of the doctors there. Keep making noise until someone listens to you. Sometimes, that's the only way to make sure you're getting the best possible health care. Good luck.

By anon259629 — On Apr 07, 2012

I've had sinus problems for years; they were first formally recognized in 1990. I had a sinus wash out operation in 1996, but the relief it offered was only temporary, and by the following year I was getting infections again.

My sinus and respiratory problems have been a nightmare. I get the impression that many doctors and general practitioners' surgeries do not take them seriously. I've been repeatedly fobbed off with excuses such as, "Maybe it's just a cold", or "You must be run down", as well as being told by doctors, "We know you're just prone to it.” The last comment gave me the impression that my doctors had just given up.

Over the last few years, the treatment that I have received has been minimal. I've had several ear, nose and throat consultations and CT scans. Every time, I've been told that "nothing has been found.” I've been left wondering all the time what is causing my sinus problems. I generally get at least three or four infections a year. I'm repeatedly fobbed off with antibiotics over the telephone; my GP does not even bother to see me in person! My ENT consultant is also disinterested, and simply tries to insist that I use inhaled nasal steroids. This is despite the fact that I have repeatedly informed him that using these steroids gives me bad nosebleeds.

I am angry and upset, and feel I am not being listened to. Recently I got so fed up that I demanded to see my medical records. It turns out that I have a deviated septum, and an untreated concha bullosa. I also have congenital hypoplasia of the left frontal sinuses. My most recent CT scans in 2010 and 2011 showed that all these problems still persisted, but my ENT consultant told me he found "nothing.”

I truly think that I am being denied treatment options, including surgery. I feel that my doctors are being dishonest regarding my treatment, and are withholding vital information about my scans and test results. I have been subjected to bullying at work due to the recurrent nature of my sinus infections, and it's making me really miserable. I get the impression that my doctors are trying to give me the cheapest treatment possible, and are hoping that I'll just put up with my discomfort and unpleasant symptoms.

Anybody have any advice as to what I can do? --Elaine.

By StarJo — On Jul 19, 2011

@seag47 - I went through about a year of medical treatment before my doctors decided that I had concha bullosa and needed surgery. I, too, had chronic sinusitis, but my doctor did not realize that it was caused by my concha bullosa, which had trapped infected pus inside of it.

Before finally doing scans on me, my doctor gave me 6 weeks worth of antibiotics. When these didn’t work, he gave me a steroid spray. He performed bacterial cultures to check for resistant bacteria.

When all else failed, he finally gave me a CT scan and discovered the root of the problem. Surgery relieved the sinusitis.

By seag47 — On Jul 18, 2011

I had to have surgery because of concha bullosa. I had developed chronic sinusitis. I had several sinus infections, with one appearing right after the last had started to subside. I kept headaches because of my sinus problems.

My doctor told me that since my sinuses had remained infected for more than 45 days, they were really inflamed and would not respond to medicine. So, he sent me to a specialist for surgery.

The specialist removed the tiny layers of bone that had become chronically infected. He improved my drainage, and I finally got some relief once the inflammation from surgery subsided.

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