The degree of concha bullosa pneumatization and its association with severity of deviated nasal septum in patients of southern region in Saudi Arabia


  • Musleh Mubarki Department of ORLHNS, Aseer central Hospital, Asir, KSA
  • Radeif Shamakhi Department of ORLHNS, Prince Mohammed Hospital, Jizan, KSA
  • Ramzi Daghriri Department of ORLHNS, Military Hospital of southern region, Jizan, KSA
  • Ali Alzarei Department of ORLHNS, Aseer central Hospital, Asir, KSA
  • Khaled Hakami



Concha bullosa, Computed tomography, Nasal septum


Background: To determine the degree of concha bullosa pneumatization and its association with deviated nasal septum in patients of southern region in Saudi Arabia.

Methods: This study used a retrospective radiological design to analyze computed tomography scans of 117 patients aged between 18 and 80 years of southern region in Saudi Arabia were used in this study. Patients with altered anatomy (iatrogenic or pathological) were excluded, CT scans were analysed to determine. The degree of concha bullosa and its association with deviated nasal septum in patients of southern region in Saudi Arabia, and the correlation between them.

Results: Forty percent (40%) cases were male and sixty percent (60%) were female. Concha bullosa (CB) were found in 17(14.5%) cases, of which 4 cases (23%) were bilateral and 13(76%) were unilateral. 7(53%) of unilateral cases were on right side, 6(47%) on left side. From all CB patients in this sample size, 15 (88%) cases have deviated nasal septum that range from mild to severe type whereas 2(12%) cases have no deviated nasal septum. Only 1 of those patients with severe deviated nasal septum has extensive type of concha bullosa.

Conclusions: Our findings revealed that there is no relationship between degree of pneumatization of CB and severity of deviated nasal septum.


Tomblinson CM, Cheng MR, Lal D, Hoxworth JM. The Impact of Middle Turbinate Concha Bullosa on the Severity of Inferior Turbinate Hypertrophy in Patients with a Deviated Nasal Septum. AJNR Am J Neuroradiol. 2016;37(7):1324-30.

Stuck BA, Hummel T. Olfaction in allergic rhinitis: A systematic review. J Allergy Clin Immunol. 2015;136(6):1460-70.

Aktas D, Kalcioglu MT, Kutlu R, Ozturan O, Oncel S. The relationship between the concha bullosa, nasal septal deviation and sinusitis. Rhinology. 2003 Jun;41(2):103-6.

Kim WJ, Terada N, Nomura T, Takahashi R, Lee SD, Park JH, et al. Effect of formaldehyde on the expression of adhesion molecules in nasal microvascular endothelial cells: the role of formaldehyde in the pathogenesis of sick building syndrome. Clin Exp Allergy. 2002;32(2):287-95.

Prasad S, Ahlawat B, Kumar A, Naik SM, Agrawal A, Nagvanshi A. Concha Bullosa and Its Association with Chronic Sinusitis. IOSR J Dent Med Sci. 2016;15(2):27-32.

Vaid S, Vaid N. Normal Anatomy and Anatomic Variants of the Paranasal Sinuses on Computed Tomography. Neuroimaging Clin N Am. 2015;25(4):527-48.

Rak KM, Newell JD, Yakes WF, Damiano MA, Luethke JM. Paranasal sinuses on MR images of the brain: significance of mucosal thickening. AJR Am J Roentgenol. 1991;156(2):381-4.

Maraghy A, Allah A, Yonis MAAM, Sharkawy MA, Zewail AGEE. Comparison between lateral partial turbinectomy and conchoplasty for concha bullosa. Egypt J Hosp Med. 2018;73(3):6348-53.

Unlü HH, Akyar S, Caylan R, Nalça Y. Concha bullosa. J Otolaryngol. 1994;23(1):23-7.

Blaugrund SM. Nasal obstruction. The nasal septum and concha bullosa. Otolaryngol Clin North Am. 1989 Apr;22(2):291-306.

Donn SM, Faix RG. Long-term prognosis for the infant with severe birth trauma. Clin Perinatol. 1983;10(2):507-20.

Kucybała I, Janik KA, Ciuk S, Storman D, Urbanik A. Nasal Septal Deviation and Concha Bullosa - Do They Have an Impact on Maxillary Sinus Volumes and Prevalence of Maxillary Sinusitis? Pol J Radiol. 2017;82:126-33.

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):1613-8.

Li L, Zang H, Han D, Ramanathan M, Carrau RL, London NR. Impact of a Concha Bullosa on Nasal Airflow Characteristics in the Setting of Nasal Septal Deviation: A Computational Fluid Dynamics Analysis. Am J Rhinol Allergy. 2020;34(4):456-62.

Sarna A, Hayman LA, Laine FJ, Taber KH. Coronal imaging of the osteomeatal unit: anatomy of 24 variants. J Comput Assist Tomogr. 2002;26(1):153-7.

Kapusuz GZ, Ozkırış M, Okur A, Karaçavuş S, Saydam L. The effect of nasal septal deviation on maxillary sinus volumes and development of maxillary sinusitis. Eur Arch Otorhinolaryngol. 2013;270(12):3069-73.

Sazgar AA, Massah J, Sadeghi M, Bagheri A, Rasool E. The incidence of concha bullosa and the correlation with nasal septal deviation. B-ENT. 2008;4(2):87-91.

Miranda CMNR, Maranhão CPM, Arraes FMNR. Anatomical variations of paranasal sinuses at multislice computed tomography: what to look for. Radiol Bras. 2011;44(4):256-62.

Uygur K, Tüz M, Doğru H. The correlation between septal deviation and concha bullosa. Otolaryngol Head Neck Surg. 2003;129(1):33-6.






Original Research Articles