Chronic Cough: The Role of Concha Compression Syndrome—A Retrospective Analysis

Abstract

Objective: Chronic cough is a common condition that significantly impairs quality of life, yet its etiology remains unidentified in some patients despite comprehensive evaluation. Concha Compression Syndrome (CCS), characterized by septal spur–induced turbinate compression and conchal indentation, is an underrecognized rhinological disorder whose association with chronic cough remains unclear. This study evaluated the clinical, radiological, and laboratory characteristics of the syndrome, with a particular focus on chronic cough.
Methods: This retrospective case–control study included 97 patients with the syndrome and 78 controls with isolated nasal septal deviation without radiological evidence of the condition. Demographic characteristics, clinical findings, paranasal sinus computed tomography findings, and laboratory parameters were compared. Chronic cough was defined as lasting ≥8 weeks. Continuous variables were compared using the Mann–Whitney U test and median test, whereas categorical variables were compared using Pearson's chi-square test or Fisher's exact test, as appropriate.
Results: Demographic characteristics were similar between groups. Compared with controls, affected patients had a considerably higher frequency of chronic cough (76.3% vs. 32.1%, p<0.001). Nasal obstruction (62.9% vs. 39.7%, p=0.002) and postnasal drip (66.0% vs. 33.3%, p<0.001) were also more common. As expected from the diagnostic criteria, septal spur-induced turbinate compression and conchal indentation were present in patients with CCS and absent in controls. Turbinate hypertrophy was also more frequent in the CCS group, whereas headache, facial pain, rhinitis, and olfactory dysfunction did not differ significantly between groups. No statistically significant differences were identified between the groups in hematological, inflammatory, or allergic biomarkers.
Conclusions: CCS was associated with chronic cough and characteristic radiological findings, while no significant between-group differences were observed in the measured systemic inflammatory and allergic biomarkers. These findings suggest that localized mechanical-contact and possible neurogenic mechanisms may contribute to this clinical association.

Keywords

• Concha compression syndrome
• Chronic cough
• Nasal obstruction
• Postnasal drip
• Nasal turbinates
• Tomography
• X-Ray computed

Ethical Statement

This non-interventional retrospective study was approved by the Institutional Ethics Committee (No. 26-68; 17 April 2026). The requirement for written informed consent was waived due to the retrospective study design.

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