scholarly journals Olfactory neuroepithelium in the middle turbinate: is there any impact on olfaction function after lateral marsupialization for concha bullosa surgery?

2021 ◽  
Author(s):  
Onur İsmi ◽  
Feyzi Meşe ◽  
Harun Gür ◽  
İclal Gürses ◽  
Yusuf Vayısoğlu ◽  
...  
Keyword(s):  
Middle Turbinate ◽  
Concha Bullosa ◽  
Olfactory Neuroepithelium

scholarly journals Evaluation of the Prevalence of Concha Bullosa in Cone-Beam Computed Tomography Images

2020 ◽  
Vol 12 (3) ◽  
pp. 93-96
Author(s):  
Nasim Shams ◽  
Bahareh Shams ◽  
Zahra Sajadi
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Middle Turbinate ◽  
Cone Beam ◽  
P Value ◽  
Concha Bullosa ◽  
Computed Tomography Images ◽  
Significant Difference ◽  
And Gender ◽  
Sinus Ostium

Background: The ostiomeatal complex (OMC) is not a separate anatomical structure although it is a functional unit of structures, including the middle meatus, uncinate process, infundibulum, maxillary sinus ostium, ethmoidal bulla, anterior ethmoid sinus ostium, and frontal recess. Concha bullosa is the pneumatization of the concha, which is one of the most common anatomical variations in the middle turbinate. Methods: This study was conducted using the cone-beam computed tomography (CBCT) images of 172 patients in the archives of the Department of Oral and Maxillofacial Radiology, Dentistry School, Ahvaz Jundishapur. Patient information including age and gender, presence or absence of concha bullosa, the involved side (left or right), and its type (i.e., extensive, lamellar, and bulbous) were collected in the information form. Finally, the chi-square test (with SPSS, version 22) was used to analyze the data, and P value less than 0.05 was considered statistically significant. Results: Patients with and without concha bullosa were 39.1 and 41.7 years, respectively, but it was no significant difference in terms of age (P = 0.321). Out of 52 patients with concha bullosa, 19 (36.5%) cases were males and 33 (63.5%) of them were females. The prevalence of concha bullosa was higher for the bilateral side (20 patients, 38.5%, P = 0.000). The prevalence of bulbulsand lamellar-shape was nearly the same (32.7% and 30.8%, respectively). Eventually, the extensive shape with 36.5% was more frequent for the shape of concha bullosa (P = 0.000). Conclusions: The prevalence of concha bullosa was high. There was no significant difference in terms of age (P = 0.321) and gender (P = 0.058) of patients with concha bullosa. The extensive type and the bilateral appearance of concha bullosa were more significant (P = 0.000).

An artificial intelligence algorithm that identifies middle turbinate pneumatisation (concha bullosa) on sinus computed tomography scans

2020 ◽  
Vol 134 (4) ◽  
pp. 328-331 ◽  
Author(s):  
P Parmar ◽  
A-R Habib ◽  
D Mendis ◽  
A Daniel ◽  
M Duvnjak ◽  
...  
Keyword(s):  
Neural Network ◽  
Artificial Intelligence ◽  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Convolutional Neural Network ◽  
Middle Turbinate ◽  
Concha Bullosa ◽  
Computed Tomography Images ◽  
Computed Tomography Scans ◽  
Neural Network Algorithm

AbstractObjectiveConvolutional neural networks are a subclass of deep learning or artificial intelligence that are predominantly used for image analysis and classification. This proof-of-concept study attempts to train a convolutional neural network algorithm that can reliably determine if the middle turbinate is pneumatised (concha bullosa) on coronal sinus computed tomography images.MethodConsecutive high-resolution computed tomography scans of the paranasal sinuses were retrospectively collected between January 2016 and December 2018 at a tertiary rhinology hospital in Australia. The classification layer of Inception-V3 was retrained in Python using a transfer learning method to interpret the computed tomography images. Segmentation analysis was also performed in an attempt to increase diagnostic accuracy.ResultsThe trained convolutional neural network was found to have diagnostic accuracy of 81 per cent (95 per cent confidence interval: 73.0–89.0 per cent) with an area under the curve of 0.93.ConclusionA trained convolutional neural network algorithm appears to successfully identify pneumatisation of the middle turbinate with high accuracy. Further studies can be pursued to test its ability in other clinically important anatomical variants in otolaryngology and rhinology.

Middle Turbinate Headache Syndrome

1993 ◽  
Vol 7 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Ari J. Goldsmith ◽  
Gerald D. Zahtz ◽  
Arsen Stegnjajic ◽  
Mark Shikowitz
Keyword(s):  
Inflammatory Disease ◽  
Facial Pain ◽  
Clinical Presentation ◽  
Middle Turbinate ◽  
Trigger Points ◽  
Sensory Innervation ◽  
Lateral Nasal Wall ◽  
Concha Bullosa ◽  
Headache Syndrome ◽  
Sinus Mucosa

Sinus headaches are attributed to inflammatory disease of the sinus mucosa or ostium. In 1948 H.G. Wolff first recognized that sinus headaches may occur in the absence of inflammatory sinusitis, and may be due to contact between strategic “trigger points” in the sinonasal passages. Since this time there have been sporadic reports of headaches and facial pain due to an enlarged middle turbinate contacting either the septum or lateral nasal wall. It is theorized that an enlarged middle turbinate, most commonly due to pneumatization (concha bullosa), can contact the septum or lateral nasal wall and give headaches referred to the ophthalmic division of the trigeminal nerve, the main sensory innervation of the anterior middle turbinate. Middle turbinate headache syndrome is reviewed, with attention to pathophysiology, clinical presentation, and treatment. Eight cases of middle turbinate headache will be presented in support of this clinical entity. We hope to alert the clinician to a relatively unknown source of recurrent headaches, that may be readily treated by otolaryngologists.

Concha bullosa: reducing middle meatal adhesions by preserving the lateral mucosa as a posterior pedicle flap

2004 ◽  
Vol 118 (10) ◽  
pp. 799-803 ◽  
Author(s):  
Elizabeth A.W. Sigston ◽  
Claire E. Iseli ◽  
Tim A. Iseli
Keyword(s):  
Middle Turbinate ◽  
Pedicled Flap ◽  
Lateral Nasal Wall ◽  
Consecutive Series ◽  
Concha Bullosa ◽  
Modified Technique ◽  
Pedicle Flap ◽  
Simple Modification ◽  
Mucosal Flap

Background: Concha bullosa, an extensively pneumatized middle turbinate, may obstruct the paranasal sinuses. Messerklinger’s partial lateral turbinectomy is commonly used to debulk the concha bullosa, leaving a raw surface with the potential for adhesions.Materials and methods: A modified technique of partial lateral turbinectomy is described. A posterior pedicled mucosal flap covers the inferior raw surface of the medial lamella of the middle turbinate. Three-month follow up of a consecutive series is compared with concurrent controls. Results: Two (7 per cent) of 28 posterior pedicled flap and four (21 per cent) of 19 traditional partial lateral turbinectomies developed mild middle meatal adhesions (p = 0.011). Posterior pedicled flap reduced the need for post-operative cleaning of the middle meatus.Conclusion: The posterior pedicled mucosal flap is a simple modification to partial lateral turbinectomy that covers the raw surface facing the lateral nasal wall, significantly reducing adhesions and speeding recovery.

scholarly journals Fungus ball in concha bullosa, an unusual site: a case report from hilly region

2017 ◽  
Vol 4 (1) ◽  
pp. 301
Author(s):  
Shaweta . ◽  
R. S. Minhas ◽  
Vineeta Sharma ◽  
Santwana Verma ◽  
Trilok C. Guleria
Keyword(s):  
Case Report ◽  
Sphenoid Sinus ◽  
Case Reports ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Fungus Ball ◽  
Concha Bullosa ◽  
Rare Presentation ◽  
Unusual Site ◽  
Hilly Region

<p class="abstract"><span lang="EN-IN">Fungus is a rare cause of rhinosinusitis in children. Its incidence has been reported as ranging between 13.5 and 28%. Fungus balls are extramucosal tangled masses of fungal hyphae. It commonly involves just one paranasal sinus. Most commonly maxillary sinus is involved and occasionally sphenoid sinus. Concha bullosa is one of the most common anatomical variations in the nasal cavity, with a frequency of reporting ranging from 14-53.6%. There are very few case reports in which Concha bullosa was affected with fungus ball. In this case report 13 years female child presented with complaints of swelling right cheek. The patient underwent endoscopic sinus surgery and there was involvement of concha bullosa and sphenoid sinus with fungus ball. Fungus was confirmed on microscopic examination and culture. Fungus ball is a rare presentation of fungal rhinosinusitis. It should be considered in enlarged middle turbinate with heterogenous opacity on CT. The diagnosis should be confirmed by microscopy or culture.</span></p>

scholarly journals Septated concha bullosa in an antrochoanal polyp patient

2017 ◽  
Vol 5 (12) ◽  
pp. 5450
Author(s):  
Suha Ertugrul
Keyword(s):  
Soft Tissue ◽  
Maxillary Sinus ◽  
Male Patient ◽  
Middle Turbinate ◽  
Antrochoanal Polyp ◽  
Concha Bullosa ◽  
Soft Tissue Masses

The term of septated concha bullosa has been described recently and it is an uncommon pneumatization anomaly of the middle turbinate. Solitary, benign soft tissue masses originating at the maxillary sinus and extending to the nasopharynx are called antrochoanal polyps. Antrochoanal polyp may be accompanied by concha bullosa. However, combination of septated concha bullosa and antrochoanal polyp has never been reported to the best of our knowledge. This paper presents a 45-year-old male patient who has a combination of septated concha bullosa and antrochoanal polyp.

scholarly journals Radiological significance of the sinonasal anatomical variants in recurrent acute rhinosinusitis patients

2017 ◽  
Vol 5 (6) ◽  
pp. 2379
Author(s):  
Niranjan Sahu ◽  
Satya Sundar G. Mohapatra ◽  
Siba N. Rath ◽  
Rabindra N. Padhy
Keyword(s):  
Nasal Septum ◽  
Middle Turbinate ◽  
Uncinate Process ◽  
Sinus Surgery ◽  
Concha Bullosa ◽  
Deviated Nasal Septum ◽  
Anatomical Variants ◽  
Acute Rhinosinusitis ◽  
Computed Tomography Images ◽  
Osteomeatal Complex

Background: Recurrent acute rhinosinusitis (RARS), a low form chronic rhinosinusitis is frequently under evaluated. The significance of sinonasal anatomical variants of osteomeatal complex (OMC) and spheno-ethmoidal (SE) recess regions in patients of RARS is assessed.Methods: Retrospective analysis of coronal sinonasal computed tomography images of 120 RARS patients presented with sinonasal anatomical variants during November 2013 to October 2016 was carried out. Patients with acute and expansile sinonasal lesions are excluded.Results: Sinonasal anatomical variants in the regions of OMC and SE recess are responsible for obstruction of normal mucociliary drainage of corresponding paranasal sinuses in presence of inflammation predisposing to RARS. Anatomical variants of nasal septum were, deviated nasal septum (DNS) in 86 (72%) and septal spur in 58 (48%) patients. Anatomical variants in OMC region were, pneumatized middle turbinate (concha bullosa) in 50 (48%), paradoxical middle turbinate in 38 (28%), giant ethmoid bulla in 35 (32%), agger nasi cell in 29 (38%), Haller cell in 23 (15%), pneumatised uncinate process in 20 (18%), medialized uncinate process in 18 (22%) and septated maxillary sinus in 5 (4%) patients. Anatomical variants in SE recess were superior concha bullosa in 14 (12%) and septal bullosa in 11 (9%) patients.Conclusions: OMC pattern of recurrent rhinosinusitis is often prevalent in patients of RARS due to abundance of anatomical variants in the OMC region. DNS or ethmoid bulla when gets associated with concha bullosa increased the incidence of RARS. Present analysis would help surgeons to evaluate RARS patients for selective endoscopic sinus surgery.

scholarly journals Anatomical variations in patients with chronic sinusitis

2018 ◽  
Vol 4 (2) ◽  
pp. 428 ◽  
Author(s):  
Pragadeeswaran Kumarasekaran ◽  
Rajprakash Dharmapuri Yadhava krishnan ◽  
Gurumani Sriraman
Keyword(s):  
Nasal Septum ◽  
Chronic Sinusitis ◽  
Anatomical Variation ◽  
Middle Turbinate ◽  
Anatomical Variations ◽  
Uncinate Process ◽  
Sinus Surgery ◽  
Concha Bullosa ◽  
Deviated Nasal Septum ◽  
Anatomical Variant

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">C</span><span lang="EN-IN">hronic sinusitis is repeated bouts of acute infection or persistent inflammation of the sinuses. The range of anatomic variants that can interfere with the mucociliary drainage of osteomeatal complex including concha bullosa, deviated nasal septum, uncinate process variations, ethmoid bulla, paradoxical middle turbinate, agger nasi and Haller cells. This is also important in surgeon point of view to know about detail knowledge of lateral nasal wall, paranasal sinuses, surrounding vital structures and anatomical variation. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Observational case series study in which 90 cases of chronic rhinosinusitis patients attending the ENT outpatient department from November-2015 to November-2016 in Shri Sathya Sai Medical college and Hospital, who had chronic sinusitis for more than three months duration not responding to the medical line treatment and who are willing to undergo functional endoscopic sinus surgery are studied and statistically analysed.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">In our study we found anatomical variation in 93% of chronic sinusitis patients. In our study it was observed that 52% of patients with two anatomical variation, 41% patients presented with single anatomical variation and 7% patients presented with no anatomical variation. In our study deviated nasal septum was the most common anatomical variant noted followed by unilateral concha bullosa, medialized uncinate process, paradoxical middle turbinate, haller cell and agger nasi. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">In our study it was concluded that presence of anatomical variations is common in patients with chronic sinusitis. Presence of more than one anatomical variations significantly contributes to disease process.<strong> </strong>Deviated nasal septum is the most common anatomical variation in our study followed by concha bullosa, medialized uncinate process.</span></p>

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