A. S. Aruna Kumari1, Juveria Majeed2, Sravan Kumar3
The approach to patients with chronic rhinosinusitis has been changed with arrival of endoscopic functional surgery of paranasal sinuses and nasal cavity. Computed tomography has become indispensable to surgical planning since it allows a detailed study of the whole structure of this region. Paranasal sinuses and nasal cavity anatomical variants are usual findings with estimated prevalence of 65% on CT scans. Concha bullosa is a result of pneumatisation of the osseous plate of the middle turbinate due to ethmoidal extension is one of the commonest variant. It may occur at several degrees from that affecting only the bulbous portion (distal) or lamellar portion (proximal) or true variation where there is pneumatisation of both portions. It has been postulated that the enlarged middle turbinate has a negative influence on sinus ventilation and mucociliary clearance in ostiomeatal unit.
Objective of the study is:
1. To estimate incidence of concha bullosa, its types, laterality and pathology within.
2. To evaluate contribution of concha bullosa in pathogenesis of inflammatory sinus disease.
3. To estimate incidence of associated anatomical variations.
MATERIALS AND METHODS
Study included 100 patients from Department of ENT, Gandhi hospital, Secunderabad. 50 patients with sinusitis who underwent endoscopic sinus surgery were included into study group. 50 patients who had nonsinogenic pain were included into control group. CT scan and endoscopic preoperative findings were noted and evaluated using Fisher test.
RESULTS AND CONCLUSIONS
This study showed incidence of concha bullosa as 43% with male preponderance and higher incidence among middle aged (20-40 years). Intralamellar type of concha bullosa was commonest in the study. Right laterality was commonly seen among concha bullosa patients. Absence of inferior turbinate hypertrophy was strongly associated with presence of concha bullosa. Maxillary and ethmoid sinusitis were the associated sinus inflammation noticed in the study. Study also showed low recurrence rate in patients who underwent conchoplasty.