The incidence of middle turbinate concha bullosa and its relationship to maxillary sinusitis, computed tomography-based study

Background: Concha bullosa (CB), pneumatization of a nasal turbinate, is a common anatomical variation, most frequently affecting the middle turbinate. Its role in the pathogenesis of maxillary sinusitis (MS) remains debated, with particular interest in the impact of CB size. Computed Tomography (CT) is the gold standard for evaluating sinonasal anatomy.

Objective: This study aimed to investigate the incidence of concha bullosa in middle turbinate and its relationship to maxillary sinusitis in a cohort of 150 patients using CT imaging, with a focus on demographic factors and the significance of large concha bullosa.

Methods: A retrospective analysis of paranasal sinus CT scans from 150 adult patients (age 18-65 years) was conducted. Data on age, gender, presence and type of CB (classified as small/medium or large, with large CB defined as occupying >50% of the middle meatus height), and presence of MS were collected. Statistical analysis, including chi-squared tests, was performed to assess associations, with p < 0.05 considered significant.

Results: The mean age of the 150 patients was 41.02 ± 13.52 years, with 78 (52.00%) females and 72 (48.00%) males. Concha bullosa was present in 87 patients (58.00%). Maxillary sinusitis was identified in 48 patients (32.00%). No statistically significant association was found between the overall presence of concha bullosa and maxillary sinusitis (p = 0.5561). However, a highly significant association was observed between large concha bullosa and maxillary sinusitis (p < 0.0001), with 69.23% of patients with large CB also having MS.

Conclusion: Concha bullosa is a frequent anatomical variant, found in 58.00% of this cohort. Its overall presence did not show a statistically significant correlation with maxillary sinusitis in this study. However, large concha bullosa was strongly associated with an increased incidence of maxillary sinusitis, suggesting that the size of the concha bullosa is a critical factor in its potential to contribute to sinus pathology. These findings underscore the importance of detailed CT evaluation, particularly of CB size, in patients with sino-nasal symptoms.