Concha Bullosa

A concha bullosa (con-KUH bull-OH-suh) is an air-filled space inside the middle of one of the bones in your nose. These nose bones are called turbinates. You have three turbinates on each side of your nose. They’re like small, curved shelves. They help warm and moisten the air as you breathe through your nose.

A concha bullosa is usually harmless and doesn’t cause any problems. Many people have one. Providers usually consider it a normal difference in healthy noses.

But if the air pocket is large, it can block airflow or sinus drainage. This could make it harder to breathe through your nose. Also, if you need sinus surgery, your provider needs to know about it. This helps them plan for surgery to avoid complications.

Symptoms of a concha bullosa

A concha bullosa doesn’t usually cause symptoms. But if it’s big, it can make it harder to breathe. It can make it harder for mucus to drain from your sinuses, too. Symptoms include:

• A blocked or stuffy nose
• Facial pain
• Headache
• Sinus pressure

The soft tissue lining your turbinates is the same as the tissue that lines your nasal cavities. Like this tissue, it can become inflamed. This means that if the turbinate with a concha bullosa gets inflamed, you may have symptoms of sinusitis.

Concha bullosa causes

Doctors don’t know what causes a concha bullosa. But some believe it forms when children are still growing. Likely, it starts around age 7 and continues to form past adolescence.

They do know that you’re more likely to have a concha bullosa if you have a deviated (off-center) septum. Your septum separates your left and right nasal cavities. But it’s unclear what the relationship is. And not everyone with a concha bullosa has a deviated septum.

How doctors diagnose this condition

A CT scan can show if you have a concha bullosa. It allows healthcare providers to see the air pocket in the bone. An air pocket can form in any turbinate, but it’s most common in the middle one. You may have a concha bullosa in just one nasal cavity (unilateral). Or you may have it in both (bilateral).

Your provider may also find it during a nasal endoscopy. This procedure uses a small telescope with a light and camera at the end to see inside your nose. You may get this done before a procedure on your sinuses. It’s important for providers to look for a concha bullosa when they’re planning surgery. It helps them know where to make incisions (cuts).

How is it treated?

You won’t need treatment unless you’re having symptoms. If you are, medicines like nasal decongestants and corticosteroids can provide relief.

But you may need surgery to get rid of a concha bullosa. It’s usually a quick, minimally invasive procedure. Options include:

• Crushing: This approach squeezes the turbinate to release the air inside the pocket.
• Functional endoscopic sinus surgery: This procedure uses an endoscope and tiny surgical tools to remove tissue blocking your airway.
• Turbinate reduction: This technique removes part of the turbinate containing the air pocket. That way, air can flow through your nasal passages more easily.

You may get a septoplasty if a deviated septum is also causing issues. A septoplasty straightens an off-center septum (the wall that divides your right and left nasal passages).

When should I see my healthcare provider?

Your provider will let you know when you’ll need follow-ups after surgery. In the meantime, reach out if you have questions about recovery.

Let them know if you’re having trouble managing symptoms after treatment. For example, if you have allergies, you may need long-term solutions to calm inflammation inside your nose. You may need medicine in addition to surgery.

What can I expect if I have this condition?

Surgery for a concha bullosa that’s causing issues has an excellent outlook. Most people experience symptom relief afterwards.

What happens if a concha bullosa is left untreated?

Not all concha bullosas require treatment. For example, studies show that it doesn’t increase your risk of sinus infections. A concha bullosa isn’t something to be concerned about unless you’re experiencing bothersome symptoms.

What is the best treatment for concha bullosa?

The best treatment is the one that manages symptoms. If you don’t have symptoms, you likely won’t need treatment. If you do have symptoms and medicines help, you likely won’t need surgery. But if medicines aren’t doing the trick, you may need surgery. The important thing to know is that treatments are available to help you get relief.