Concha Bullosa: A Shield against Allergens?
OBJECTIVE
Concha bullosa (CB) alters the intranasal anatomy and may influence the buffering of inhalant allergens and the inflammatory microenvironment central to chronic rhinosinusitis (CRS). By investigating the link between allergies and CB, we can examine this theoretical benefit, which has implications on the extent of resection in endoscopic sinus surgery.


METHODS
Forty-three adults treated between 2010 and March 2014 with chronic sinonasal symptoms were retrospectively analyzed by skin prick allergy testing, maxillofacial computed tomography scan, and Lund-Mackay score. x03C7;2 analysis and t tests were employed to determine statistical significance.


RESULTS
Subjects were divided into 30 positive cases and 13 pan-negative allergy controls. No difference in CB prevalence was observed between those with positive (70%) and those with negative (69.2%) allergy tests (p = 0.93). Furthermore, no association between CB and Lund-Mackay score was identified (p = 0.69). Overall, 83.3% of CB were located in the middle turbinate, 16.7% in the superior turbinate, and 20% occurred in the middle turbinate bilaterally.


CONCLUSIONS
Although an enlarged, pneumatized turbinate could function as a physical barrier to inhalant allergens, documented allergies demonstrate no association with CB formation. Furthermore, this study finds no correlation between CB and radiographic evidence of CRS.
Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pa., USA.
Douglas M
DM
Worrall
Raewyn G
RG
Campbell
James N
JN
Palmer
David W
DW
Kennedy
Nithin D
ND
Adappa
D000485:Allergens / Q000009:adverse effects*; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D065631:Rhinitis, Allergic / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D012852:Sinusitis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D012882:Skin Tests; D014057:Tomography, X-Ray Computed; D014420:Turbinates / Q000000981:diagnostic imaging* / Q000473:pathology
D000485:Allergens