Concha Bullosa Surgery

The middle part of the nose, consisting of cartilage and bone, which divides the nasal cavity into two parts, right and left, is called the septum.

Conchae (concha / turbinate) are structures consisting of bone and soft tissue inside the nose, extending in a half C-shape from the outer wall of the nose to the septum located on the middle center line. There are usually 3, sometimes 4 in each of the right and left septum. They are named as lower, middle and upper turbinates. Parallel to the structure of the nose, the lowest concha is the largest and the upper one is the smallest. The turbinate is not adenoid, as it is misunderstood among the public, but a structure with a different structure, location and function.

The turbinates are vital for many functions performed by the nose. The task of the turbinates is to slow down the air inhaled through the nose by cutting its speed, to heat the air up to about 25 0C and make it ready for entry into the lungs, to moisturize it, to clean it from foreign substances and particles and to produce some enzymes. In particular, the function of the middle turbinate is to prevent air from entering the sinuses directly through the nose. During the breathing process, the turbinates grow and shrink from time to time depending on the blood circulation in order to fulfill their functions and protect the lungs. In this way, the airways cease to be stable and take on a controllable dynamic structure that adapts to external factors.

In order to keep the nasal hairs (cilia), which filter the air and protect the lungs from dirt, dust, viruses, bacteria and toxins, moist and not dry out, both nasal cavities do not grow and shrink simultaneously and synchronously, but sequentially and in shifts. This shift of 30 minutes to 6 hours is called the nasal cycle. As the total amount of air inhaled does not change, people do not notice this difference. During the nasal cycle, one nasal cavity, the air duct, passes very little air as the turbinate swells, allowing the nasal hairs to rest, while the other ensures normal air flow.

In addition to keeping the nasal hairs rested and moist, the other task of the nasal loop is to ensure good smell. Smelling is related to the chemicals in the inhaled air. Some chemicals need to stay in the olfactory receptors for a longer time before their odor can be recognized. Chemicals in the slow-moving air in the closed nasal cavity, which passes less air during the nasal cycle, are better perceived. Recent studies suggest that the nasal cycle may even be involved in psychological disorders such as Bipolar Disorder and Schizophrenia.

What is Concha Bullosa (Air Sac Concha-Concha Bullosa)?

Concha bullosa is the formation of air cavities, air sacs (pneumatization) in the bone tissue of the concha. It is the most common anatomical disorder in the side walls of the nose. Although turbinate bullosa is rarely seen in the upper and lower turbinates, it is frequently seen in the middle turbinate. It may occur on one side of the nose or simultaneously in the turbinates of both cavities.

Concha bullosa, which generally follows a silent course without showing symptoms, causes the middle turbinate to enlarge, leading to obstruction of the middle nasal passage and air ducts to the sinuses, and as a result; chronic sinus inflammation, pressure and pain around the sinuses and eyes, chronic headache, rarely ear and jaw pain. The best diagnostic method is Computed Tomography.

Concha bullosa can be classified in three different ways according to its formation: Lamellar Concha Bullosa, Bullous Concha Bullosa and Extensive Concha Bullosa:

Lamellar Concha Bullosa: Concha bullosa in which air sacs are seen in the vertical lamella (thin layer) of the middle turbinate.

Bullous Concha Bullosa: Concha bullosa, in which air sacs are seen in the lower part of the middle turbinate, called the bulbous part.

How is Concha Bullosa (Air Sac Concha-Concha Bullosa) Surgery Performed?

Concha bullosa surgery is usually performed using one of the following methods: crushing, turbinoplasty (concha shaping) or concha resection/reduction (concha removal/reduction).

The method of Concha Bullosa surgery, which is performed by entering the nose with a camera and cutting and removing the half of the nasal flesh swollen like a balloon facing the mouth of the sinuses, is called Endoscopic Concha Resection / Reduction.

Endoscopic turbinate resection / reduction is used in cases where the bone structure is effective in turbinate growth and the desired result cannot be obtained with radio frequency application. Endoscopic turbinate resection/reduction is an effective method for the treatment of turbinate bullosa. It provides easy access to the osteomeatal complex, which is the entrance to the sinuses, without causing excessive bleeding or trauma. In addition, thanks to the minimal surgery performed, the mucosal structure outside the turbinate is not damaged, so the turbinate can fulfill its function completely after the operation and intranasal adhesions are not seen.

The microdebrider device is commonly used. With this device, only the diseased area is worked on. While the diseased tissue is removed by filing or shaving, the intervention area is simultaneously washed and vacuum cleaned to avoid damaging the surrounding healthy tissue. With this high-tech device, time and labor intensity is reduced. The procedure is completed in about half an hour. In addition, since the mucosal structure is not damaged, the need to use tampons after the operation is eliminated.

After surgery, the patient is discharged on the same day. However, the nose should be protected from traumatizing blows and excessive blowing for 3-4 days to prevent increased bleeding. The approximate recovery period is 6-8 weeks.

If you are experiencing constant nasal congestion, difficulty breathing and frequent problems such as sinusitis, headache, snoring, nasal and nasal discharge, you can contact us using our contact information.

Comments from our patientsComments from our patients

Melisa Aktürk

In my first meeting with Mr. Elad, I trusted him immediately. He is both a warm-blooded, friendly doctor and explains everything in detail and honestly. I am in the 1st month of my surgery. I had a bruise-free, painless process. I also already love the shape of my nose :) If you want a natural nose that is compatible with your face, Mr. Elad is the right choice. His team and himself are very interested. They do not think that the surgery is over. I can recommend my doctor with peace of mind. I thank him and his team endlessly.

Elif Demirtaş Kanburoğlu

When you go to him for the first interview, you will already take the day for surgery and leave :) a doctor who is so sweet and explains everything to the finest detail. I saw 1 bad comment, I think anyone who knows the deliberate Elad knows that he will not treat the patient with such a style.

Burcu Çebi

You can be sure that he will be one of the sweetest, most caring, smiling doctors you will ever see! He is a tremendous person with his beautiful work and posture. I am in the 5th month of my surgery and I am very happy that I chose him. Good thing you are Mr. Elad :) I have no doubt that you will sign many more beautiful works. And you, dear friends who want to see a procedure, research and read this comment, you will be happy if you choose Elad Bey

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