New case of concha bullosa from Bronze Age Iberia (Granada, Spain)

The incidence of concha bullosa: a retrospective radiologic study

AIM

This study was conducted to discuss the incidence, directions, and types of concha bullosa using studies in the literature.

MATERIALS AND METHODS

The images of patients who presented to the ENT clinic with different ENT symptoms in the last 7 years and had paranasal sinus tomography were analyzed retrospectively.

RESULTS

The study consisted of a total of 3133 patients, including 1534 females (48.96%) and 1599 males (51.03%). The age range of the cases was between 12 and 85 years, and the mean age was 57.25 years. Middle concha bullosa was detected in 1402 (44.74%) of the cases. Of these cases, it was determined that 320 (22.82%) had right, 311 (22.18%) had left, and 771 (54.99%) had bilateral middle concha bullosa. Of middle types of concha bullosa, lamellar type concha bullosa was detected in 575 (41.01%) patients, bulbous type in 363 (25.89%), and extensive type in 464 (33.09%). Of the cases with lamellar type middle concha bullosa, it was found that 130 (22.60%) had right side, 105 (18.26%) had left side, and 340 (59.13%) had bilateral lamellar type middle concha bullosa. Of the cases that were determined to have bulbous type middle concha bullosa, 97 (26.72%) had right side, 99 (27.27%) had left side, and 167 (46.00%) had bilateral bulbous type middle concha bullosa. Of the cases that were determined to have extensive type middle concha bullosa, 93 (20.04%) had right side, 107 (23.06%) had left side, and 264 (56.89%) had bilateral extensive type middle concha bullosa. The incidence of superior concha bullosa was determined in 487 (15.54%) of 3133 cases. Of these, bilateral superior concha bullosa was detected in 332 (68.17%) cases and unilateral in 155 (31.82%) cases.

CONCLUSIONS

Our study has the largest case series among studies investigating the incidence of concha bullosa. The incidence of concha bullosa appears to be common in the community. Additional studies may be useful to determine whether its high incidence is associated with other sinus pathologies and the extent of its effect on other rhinological complaints.

Digital imaging techniques applied to a case of concha bullosa from an early medieval funerary area in central Italy

OBJECTIVE

Concha bullosa is a rather common condition of the nasal turbinates, rarely reported in archaeological skeletal collections. This paper examines a case of concha bullosa as seen in a female cranium from a burial in central Italy, dated to the Longobard domination in the Peninsula (mid-7th- early 8th century CE).

MATERIALS

The individual under investigation (T86/17) comes from the funerary area of Selvicciola, located near the town of Viterbo in northern Latium, Italy.

METHODS

The skeleton was macroscopically examined. We analyzed the CT-scans of the defect by applying innovative R-based virtual tools.

RESULTS

It was possible to calculate the inner volume of the concha bullosa and to provide a 3D visual assessment of its shape.

CONCLUSIONS

Its size and shape suggest that the individual had this condition for a considerable period of time, during which its presence may have had affected her daily activities and health status.

SIGNIFICANCE

An under-represented paleopathological defect is examined for the first time through a virtual approach aimed at visualizing its shape and the assessment of its volume. New methods of 3D based virtual assessment can increase the informative value of defects.

SUGGESTIONS FOR FURTHER RESEARCH

Techniques used in this assessment should be considered as an evaluative tool for other conditions when macroscopic and radiographic imaging are limited.

Rare anatomic variation: Giant unilateral concha bullosa superior

The lateral nasal wall attaches the nasal turbinates, which could be, either pneumatized, or paradoxically curved. The turbinate pneumatization-concha bullosausually indicates the pneumatization of the middle turbinate. However, concha bullosasuperior (CBS) is also, although rare, anatomic possibility of variation. We report here a case of unilateral giant septated CBS, which was not, to our knowledge, previously reported. The case was documented in Cone Beam Computed Tomography (CBCT). Subtle pneumatizations of inferior turbinates were found bilateral, as also were the middle conchae bullosae. The left concha bullosasuperior was very large (17.43/5.34mm), dropping down between the left middle turbinate and the contralaterally deviated nasal septum, and contacting the paradoxical curvature of the middle turbinate on that side. An incomplete oblique septum divided it incompletely into anterior and posterior chambers, it was communicating with a posterior ethmoid air cell, and was draining in the superior meatus. Care should be taken not to misdiagnose a giant CBS as a middle turbinate pneumatization, in order not to misjudge surgical corridors. Therefore, a careful anatomic CT or CBCT diagnosis would be of use for the plan of treatment.