DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20202787

The role of concha bullosa in chronic rhinosinusitis: our experience at a tertiary care hospital

Afshan Fathima, Ramappa Arabhanvi, Karthik Shamanna, Lyra Joy

Abstract


Background: Chronic rhinosinusitis (CRS) is a common and persistent illness that otorhinolaryngologists encounter commonly. It is an important cause of morbidity and accounts for major loss of income. Anatomical variations of the lateral wall of the nose have been reported which can predispose to CRS. The aim of the present study was to determine the percentage of concha bullosa in patients with CRS and to ascertain its relationship with chronic rhinosinusitis.

Methods: 100 patients attending the ENT outpatient department, Bangalore Medical College and Research Institute between December 2018 and 2019 were included in the study. Patients clinically diagnosed as CRS underwent diagnostic nasal endoscopy (DNE) and computed tomography (CT) scan of nose and paranasal sinuses, following which the relationship between concha bullosa and CRS was determined. The results were tabulated in excel sheet. Chi square test was applied for qualitative data.  

Results: Of the 100 patients of CRS, 40 were males and 60 females. Of the 40 male patients, 16 showed presence of concha bullosa and of the 60 female patients, 28 showed concha bullosa. Headache (92%) was the most common presenting symptom in our study. A statistically significant correlation was noted between the presence of concha bullosa and chronic maxillary sinusitis (p value <0.05).

Conclusions: Concha bullosa is one of the most common anatomical variations of the lateral wall of the nose. The presence of concha bullosa plays a significant role in the development of chronic rhinosinusitis particularly in chronic maxillary sinusitis.


Keywords


Chronic rhinosinusitis, Concha bullosa, Diagnostic nasal endoscopy, Computed tomography

Full Text:

PDF

References


Stackpole SA, Edelstein DR. The anatomic relevance of the Haller cell in sinusitis. Am J Rhinol. 1997;11:219-23.

Cauwenberge PV, Watelet JB. Epidemiology of chronic rhinosinusitis. Thorax. 2000;55(2):20-1.

Zinreich S, Albayram S, Benson M, Oliverio P. The ostiomeatal complex and functional endoscopic surgery. In: Som P, ed. Head and neck imaging. 4th ed. St Louis: Mosby; 2003; 149-173.

Bolger W, Butzin C, Parsons D. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope. 1991;101:56-64.

Weinberger D, Anand V, Rawi AM, Cheng H, Messina A. Surgical anatomy and variations of the onodi cell. Am J Rhinol. 1996;10:365-70.

Lloyd GA. CT of the paranasal sinuses: study of a control series in relation to endoscopic sinus surgery. J Laryngol Otol. 1990;104:477-81.

Arslan H, Aydinlioglu A, Bozkurt M, Egeli E. Anatomic variations of the paranasal sinuses: CT examination for endoscopic sinus surgery. Auris Nasus Larynx. 1999;26:39-48.

Basic N, Basic V, Jelic M. Pneumatization of the middle nasal turbinate: a CT study. Lijec Vjesn. 1998;120:200-1.

Kangaroo SK, White PS, Lee MS. A randomized control trial of surgical task performance in frontal recess surgery: zero degree versus angled telescopes. Am J Rhinol. 2002;16(1):33-6.

Stammberger H. Endoscopic endonasal surgery - concept in treatment of recurring rhinosinusitis. Otolaryngol Head Neck Surg. 1986;94:143-56.

Kennedy DW. Functional endoscopic Sinus surgery. Technique. Arch Otolaryngol. 1985;111:643-9.

Perez P, Sabate J, Carmona A. Anatomical variations in the human paranasal sinus region studied by CT. J Anat. 2000;197:221-7.

Zinreich SJ, Mattox DE, Kennedy DW. Concha bullosa: CT evaluation. J Comput Assist Tomogr. 1988;12:778-84.

Tuli IP, Sengupta S, Munjal S, Kesari SP, Chakraborty S. Anatomical Variations of Uncinate Process Observed in Chronic Sinusitis. Indian J Otolaryngol Head Neck Surg. 2013;65(2):157-61.

Wani AA, Kanotra S, Lateef M, Ahmad R, Qazi SM, Ahmad S. CT scan evaluation of the anatomical variations of the ostiomeatal complex. Indian J Otolaryngol Head Neck Surg. 2009;61(3):163-8.

Hatipoglu HG, Cetin MA. Enis Yuksel From the Departments of Radiology and Ear, Nose and Throat Surgery (M.A.C.), Ankara Numune Research and Training Hospital, Ankara, Turkey; 2005: 145-149.

Stammberger H. Functional Endoscopic Sinus Surgery. Philadelphia: B. C. Decker. 1991:161-9.

Reda M. Concha bullosa and other sino nasal variants: clinical and CT correlation. Iranian J Radiology. 2004: 31-6.

Maru YK, Gupta V. Anatomic variations of the bone in sino nasal CT. Indian J Otolaryngol Head Neck Surg. 2001;53:123-8.

Prinja S, Davessar J, Singh G, Kansal L, Kaur J. Role of concha bullosa in etiopathogenesis of chronic rhinosinusitis: a clinical study. Int J Contemporary Med Res. 2017;4(3):774-6.