Concha bullosa and nasal septum by tomographic study; experience at the General Hospital of Mexico Eduardo Liceaga

Abstract

Introduction: Nasal septal deviation is defined as any bending of the septal contour observable on coronal computed tomography (CT) scans and is present in more than half of the population. Concha bullosa (CB) is defined as persistent pneumatisation of the middle turbinate. The purposes of this study are to identify its frequency, as well as its relationship with the deviation of the nasal septum in the population that attends the HGMEL and to propose a radiological classification according to its size and location in relation to the degree of turbinate obstruction. Method: Osteomeatal CT scans performed during one year (January-December 2020) were analysed. All cases presented deviation of the nasal septum. We use the Bolger and Calvo-Henriquez classifications and propose a classification according to the maximum size of the extension in the coronal plane (General Hospital of Mexico Eduardo Liceaga [HGMEL] Classification). Results: Of 142 CT scans of nasal sinuses, 99 were excluded because they did not present CB; as for the remaining 43 (30.28%) subject to this analysis, 27 corresponded to women (62.7%). The incidence of unilateral type CB was 65.12% and that of the bilateral type of 34.88%, with left unilateral CB in 57.14% of cases. The most frequent forms were type 2 (lamellar) with the Bolger classification, type I with the Calvo-Henríquez classification, and grade 1 according to the HGMEL classification. Conclusion: The proposed classification is based on the involvement of the middle turbinate caused by the deviation of the septum due to its anatomical and physiological importance. It is important as a surgical reference and can be easily studied on the preoperative CT scan.