What Is Concha Bullosa and How Is It Managed?

Medically reviewed by Alana Biggers, MD on August 10, 2017Written by Tim Jewell on August 10, 2017

What is concha bullosa?

The conchae are structures made of bone inside of your nose. They help control the airflow into your nose. They also clean and warm air that you’ve inhaled so that it’s ready to go to your lungs for respiration. Respiration is the process of breathing in and out.

Concha bullosa happens when one of the conchae, or turbinates, inside your nose becomes filled with a pocket of air. This is also known as pneumatization of the turbinate.

There are three pairs of conchae in your nose on either side of the septum. Your septum is the structure that divides your nose in half.

These conchae include:

  • The superior turbinates, which are the highest conchae in your nose, near your brain. These protect the olfactory bulb, the part of your brain that helps you smell.
  • The middle turbinates, which sit between the superior and inferior conchae. They help keep inhaled air from going directly into your sinuses.
  • The inferior turbinates, which are the lowest conchae in your nose. They help moisturize and warm up inhaled air before it goes into your lungs.

You may notice some pain or discomfort around your sinuses when the middle turbinates get filled with an air pocket.

In many cases, you won’t have to see a doctor or get treated for concha bullosa. But the bigger the air pocket is, the more discomfort you’re likely to experience. Untreated concha bullosa can also cause more uncomfortable conditions, including sinus infections.

How to recognize the symptoms

A small concha bullosa usually doesn’t cause any noticeable symptoms. You can have a concha bullosa in your nose throughout your life and never realize it.

The larger a concha bullosa grows, the more pain and discomfort you’re likely to feel. The most common symptoms include:

  • pressure or pain around your sinuses and the area around your eyes
  • feeling like you can’t get enough air in or out of your nose
  • feeling that something is in the way inside your nostrils

The symptoms of concha bullosa can feel like those of sinusitis or a sinus infection. These conditions can also make you feel like you can’t breathe out of your nose very well. However, concha bullosa typically doesn’t cause ear and jaw pain, mucus drainage, or other associated symptoms.

Causes of concha bullosa

It’s not clear what exactly causes concha bullosa. Some research suggests that it’s more likely to happen if you have a deviated septum. This means that the septum isn’t completely straight, which can make it harder to breathe through one of your nostrils. A deviated septum can cause other symptoms as well, like loud snoring and sleep apnea.

How it’s diagnosed

If a concha bullosa isn’t affecting your ability to breathe normally, you likely don’t need to see your doctor.

If your symptoms affect your quality of life, your doctor may suggest an imaging test so that they can view and diagnose a possible concha bullosa. Then they can help treat it.

The most common imaging test done for concha bullosa is a CT scan. This test allows your doctor to see a cross-section of your nose and the conchae structures so that they can spot any air pockets. The pockets usually appear as black spots where the conchae normally appear gray. Many concha bullosa often look like large round circles or as large pockets extending off other parts inside your nose.

Your doctor may also use a MRI test to look for concha bullosa. MRI images show the three-dimensional structure of your nose and the conchae. Like a CT scan, an MRI test can make it easy for your doctor to spot a concha bullosa as a dark circle within the structures around your conchae.

If you have a concha bullosa causing other conditions, such as sinus infections or sinusitis, your doctor will also diagnose these conditions and develop an appropriate treatment plan.

Treatment options

You likely won’t need treatment if your concha bullosa isn’t causing you any pain or discomfort. No medication or surgery is necessary if you don’t have any symptoms.

If symptoms such as head pain or breathing difficulties are disrupting your life, your doctor may recommend surgery. They may suggest one of the following procedures:

Crushing: Your doctor uses tools to squeeze the concha bullosa until they release the air that’s inside them. This surgery may require local or general anesthesia. It’s considered safe and has few complications, if any.

Turbinoplasty: Your doctor reshapes the bones and tissue around the concha bullosa to allow air to flow through the concha more easily. This surgery usually requires general anesthesia.

Turbinate resection or reduction: Your doctor uses tools to remove some or all of the concha bullosa. This surgery usually requires general anesthesia.

Your doctor may also recommend septoplasty to correct a deviated septum to help you breathe more easily.

Most of these surgeries are covered by many insurance plans. Your insurance provider can give you more information about your individual coverage options.

Can this lead to complications?

Untreated concha bullosa can cause sinus infections. These can cause you to experience:

  • headaches
  • mucus drainage out of your nose
  • sore throat
  • cough that won’t go away

If left untreated, a sinus infection may become chronic. Chronic sinusitis can make it harder for you to breathe because your nasal airways are blocked by inflammation. It can also cause fatigue, nausea, and pain in your head, throat, and ears.

Over time, complications may cause meningitis or cause you to lose your sense of smell or vision.

Outlook

You don’t need to treat concha bullosa if they aren’t causing any symptoms. But if you have pain and discomfort or can’t breathe properly, surgery may be a good option.

Your doctor can provide you with information about your individual diagnosis and walk you through the different treatment options available to you. Not only can corrective surgery help relieve your symptoms, it may help prevent complications.

CMS Id: 130003