Reformation of concha bullosa following treatment by crushing surgical technique: implication for balloon sinuplasty.
OBJECTIVE
There are various surgical techniques designed to treat conchae bullosae (CB). These include partial or total resection and crushing. Frontal sinus balloon sinuplasty is thought to work by the crushing/remodeling of the agger nasi and frontal recess air cells. The long-term outcome of sinuplasty in the frontal/ethmoid air cell region is unknown. To date, no study has been done on the reformation of CB after crushing. We report on the long-term outcome of a series of patients who underwent crushing of their CB and suggest implications for frontal sinus balloon sinuplasty.


METHODS
Retrospective case series.


METHODS
Retrospective review of 10 patients who re-presented with CB as a component of their nasal obstructive symptoms despite previously undergoing crushing of their CB. Data analyzed included paranasal sinus computed tomography (CT) scans and operative reports.


RESULTS
These 10 patients re-presented with recurrent rhinosinusitis and nasal obstructive symptoms. The patients had previously undergone septoplasty surgery with crushing of the CB and were noted to have reformed the CB on their most recent sinus CT. The previous surgeries were preformed from 2 to 15 years prior to their representation.


CONCLUSIONS
CB can reform following crushing technique. One may extrapolate that agger nasi and frontal recess air cells may reform following balloon sinuplasty leading to recurrent obstruction of the frontal sinus outflow tract.
Harvard Vanguard Medical Associates, Boston, Massachusetts, USA.
David A
DA
Kieff
Nicolas Y
NY
Busaba
D000328:Adult; D000368:Aged; D002404:Catheterization / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015522:Frontal Sinusitis / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000601:surgery*; D015508:Nasal Obstruction / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012220:Rhinitis / Q000150:complications / Q000601:surgery*; D012225:Rhinoplasty / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014420:Turbinates / Q000601:surgery*