The Effects of Concha Bullosa on Lateral Nasal Wall Asymmetries

Year 2024, Volume: 7 Issue: 2, 61 - 66, 20.08.2024

Mehmet Ekrem Zorlu , Türker Acar , Yakup Şen Abdulhalim Aysel , Ecem Sevim Akı

Abstract

Objective: The objective is to investigate the effects of unilateral and bilateral concha bullosa (CB) on lateral nasal wall asymmetries and septal deviation.

Methods: Our study was designed retrospectively and included a total of 90 patients: 30 patients without CB (Group 1), 30 with unilateral CB (Group 2), and 30 with bilateral CB (Group 3). Septal deviation angles (SDAs), severities of nasal septal deviation (NSD) based on the NSD angle, deviation shapes, lateral nasal wall lengths, lateral nasal wallseptum distances, and lateral nasal wall morphologies were evaluated on paranasal computed tomography scans.

Results: A significant difference was observed in the SDA values among the 3 groups (P = .000). The NSD severity was different among the 3 groups (P = .003): severe deviation was observed in 5 patients (16.7%) in Group 1, 10 patients (33.3%) in Group 2, and 6 patients (20%) in Group 3. In Group 2, a significant difference was observed in the lengths of the lateral nasal walls between the side with and without CB (P = .000).

Conclusion: In patients with unilateral CB, lateral nasal wall asymmetries are frequently observed, necessitating planning for osteoplasty, osteotomy, and CB surgery before the procedure.

Keywords

Concha bullosa , crooked nose , nasal septal deviation , septorhinoplasty

References

• Balikci HH, Gurdal MM, Celebi S, Ozbay I, Karakas M. Relationships among concha bullosa, nasal septal deviation, and sinusitis: retrospective analysis of 296 cases. Ear Nose Throat J. 2016;95(12):487-491.
• Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope. 1991;101(1 Pt 1):56-64.
• Koo SK, Kim JD, Moon JS, Jung SH, Lee SH. The incidence of concha bullosa, unusual anatomic variation and its relationship to nasal septal deviation: a retrospective radiologic study. Auris Nasus Larynx. 2017;44(5):561-570.
• Özdoğan F, Özel HE, Esen E, Altıparmak E, Genç S, Selçuk A. An often neglected area in crooked nose: middle turbinate pneumatization. Braz J Orl. 2017;83(5):563-567.
• Al-Rawi NH, Uthman AT, Abdulhameed E, Al Nuaimi AS, Seraj Z. Concha bullosa, nasal septal deviation, and their impacts on maxillary sinus volume among Emirati people: a cone-beam computed tomography study. Imaging Sci Dent. 2019;49(1):45-51.
• Pérez-Piñas I, Sabaté J, Carmona A, Catalina-Herrera CJ, Jiménez-Castellanos J. Anatomical variations in the human paranasal sinus region studied by CT. J Anat. 2000;197(2):221-227.
• Ozdogan F, Ozel HE, Esen E, Genc S, Selcuk A. Medial laminectomy of the large concha bullosa in crooked nose. World J Plast Surg. 2018;7(1):132-135.
• Elahi MM, Frenkiel S, Fageeh N. Paraseptal structural changes and chronic sinus disease in relation to the deviated septum. J Otolaryngol. 1997;26(4):236-240.
• Aramani A, Karadi RN, Kumar S. A study of anatomical variations of osteomeatal complex in chronic rhinosinusitis patients—CT findings. J Clin Diagn Res. 2014;8(10):KC01-KC04.
• Min YG, Jung HW, Kim CS. Prevalence study of nasal septal deformities in Korea: results of a nation-wide survey. Rhinology. 1995;33(2):61-65.
• Yazici D. The analysis of computed tomography of paranasal sinuses in nasal septal deviation. J Craniofac Surg. 2019;30(2):e143-e147.
• Tassoker M, Magat G, Lale B, Gulec M, Ozcan S, Orhan K. Is the maxillary sinus volume affected by concha bullosa, nasal septal deviation, and impacted teeth? A CBCT study. Eur Arch Otorhinolaryngol. 2020;277(1):227-233.
• Kang DH, Park KR, Chung KJ, Kim YH. The relationship between facial asymmetry and nasal septal deviation. J Craniofac Surg. 2015;26(4):1273-1276.
• Stammberger HR. Functional endoscopic sinus surgery: The Messerklinger Technique. Philadelphia: B. C. Decker; 1991.
• El-Taher M, AbdelHameed WA, Alam-Eldeen MH, Haridy A. Coincidence of concha bullosa with nasal septal deviation; radiological study. Indian J Otolaryngol Head Neck Surg. 2019;71(suppl 3):1918-1922.
• Uygur K, Tüz M, Doğru H. The correlation between septal deviation and concha bullosa. Otolaryngol Head Neck Surg. 2003;129(1):33-36.
• Stallman JS, Lobo JN, Som PM. The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. AJNR Am J Neuroradiol. 2004;25(9):1613-1618.
• Toriumi DM. Managing the Deviated/Asymmetric Nose Deformity. Structure Rhinoplasty: Lessons Learned in 30 Years. Volume 1. Chicago: DMT Solutions; 2019:461-601.
• Seneldir S. Dorsum: Osteotomy. Photographic Atlas of Rhinoplasty. Berlin: Springer; 2021:123-175.
• Eren SB, Kocak I, Dogan R, Ozturan O, Yildirim YS, Tugrul S. A comparison of the long-term results of crushing and crushing with intrinsic stripping techniques in concha bullosa surgery. Int Forum Allergy Rhinol. 2014;4(9):753-758.
• Kumral TL, Yıldırım G, Çakır O, et al. Comparison of two partial middle turbinectomy techniques for the treatment of a concha bullosa. Laryngoscope. 2015;125(5):1062-1066.
• Jahandideh H, Maleki Delarestaghi M, Jan D, Sanaei A. Assessing the clinical value of performing CT scan before rhinoplasty surgery. Int J Otolaryngol. 2020;2020:5929754.