FREQUENCY OF CONCHA BULLOSA IN PARANASAL SINUSITIS: A CROSS-SECTIONAL STUDY

Abstract

Background: Concha bullosa, defined as pneumatization of the middle turbinate, is among the most common anatomical variations of the nasal cavity and is frequently implicated in osteomeatal obstruction. Its presence may alter airflow dynamics and contribute to chronic sinonasal inflammation. Computed tomography (CT) remains the gold standard for identifying such variants, particularly in patients evaluated for sinusitis. Despite extensive international data, local evidence remains limited, highlighting the need for population-specific research.

Objective: To determine the frequency of concha bullosa in patients with radiological evidence of sinusitis on CT imaging.

Methods: A descriptive cross-sectional study was conducted at the Department of Radiology, Islamabad Diagnostic Center, from December 2023 to May 2024. A total of 95 patients aged 18–50 years with CT-confirmed mucosal thickening in at least one paranasal sinus were enrolled through non-probability consecutive sampling. High-resolution CT scans of the paranasal sinuses were performed in standardized planes and evaluated independently by two experienced consultant radiologists to identify the presence of concha bullosa. Demographic characteristics and radiological findings were documented and analyzed using SPSS version 26.0. Associations with gender and age groups were assessed using the Chi-square test, with p ≤ 0.05 considered significant.

Results: The mean age of the participants was 33.15 ± 9.34 years, with males comprising 62.1% (n=59) and females 37.9% (n=36). Concha bullosa was identified in 41.1% (n=39) of the study population, while 58.9% (n=56) showed no pneumatization. Gender-wise prevalence was 42.4% in males and 38.9% in females, with no significant association (p = 0.738). Age-stratified analysis revealed prevalences of 32.4% (18–30 years), 37.9% (31–40 years), and 55.2% (41–50 years), though the increasing trend was not statistically significant (p = 0.162).

Conclusion: Concha bullosa emerged as a common anatomical variant in patients with radiological evidence of sinusitis, occurring in over two-fifths of the cohort. Although its distribution showed no significant gender difference, the rising trend with age suggests a potentially dynamic pattern that warrants further longitudinal evaluation. Preoperative CT detection remains essential for surgical planning and optimizing functional endoscopic sinus surgery outcomes.