The inferior concha bullosa: A rare condition with great functional impact

BACKGROUND. Pneumatization of the turbinate is also known as concha bullosa (CB). Concha bullosa is most commonly found in the middle turbinate; its occurrence in the inferior turbinate is very rare.

MATERIAL AND METHODS. A search of the literature was conducted using PubMed, Medline, Google and Google Scholar search engines using the keywords “inferior turbinate and concha bullosa”, “inferior turbinate and pneumatization”, covering the period from 1990 to 2024. Only case reports published in English were included in the study.

RESULTS. We found twenty publications with a total of 21 cases that fit the above inclusion criteria for the analysis, with our case being the 22nd. Our patient was a 32-year-old male who presented to the ENT outpatient department with complaints of nasal obstruction for two years. Diagnostic nasal endoscopy was performed and a diagnosis of deviated nasal septum (DNS) to the right and left inferior turbinate hypertrophy was made. He was started on intranasal steroids and decongestants but did not improve. Hence, CT PNS was done and revealed a left inferior concha bullosa along with right-sided DNS. Septoplasty was carried out and the left inferior turbinate was excised. Gross appearance of the turbinate confirmed the diagnosis.

CONCLUSION. Pneumatization of the inferior turbinate is a very rare anatomical anomaly. It is often asymptomatic and diagnosed incidentally on a CT scan. It can present as nasal obstruction, recurrent rhinosinusitis, and headaches. Treatment depends on the severity of symptoms.