Is it effective to use the crushing technique in all types of concha bullosa

Abstract

A prospective study to evaluate long term results of crushing technique in concha bullosa surgery with radiographic and endoscopic methods and to determine the type of concha bullosa in which crushing technique is more effective. 71 patients who underwent concha bullosa surgery with septoplasty were included in the study. All concha bullosa were divided into three groups according to their types (Group 1 lamellar type, Group 2 bulbous type, Group 3 extensive type). Crushing of the pneumatized middle turbinate was done under endoscopic view. All the patients had an endoscopic nasal examination and middle turbinates were photographed and axial and coronal paranasal computed tomography (CT) scans were taken before the surgery and approximately 2 years after the surgery. Preoperative and postoperative measurements were compared using paired t test and One-way ANOVA. Mean age of the 71 patients were as follows: 38 males, mean age 30.2 (range 20-44) years; 33 females, mean age 27.6 (range 18-40) years. The patients were followed for 22.7 (range 20-26) months. In all groups, the postoperative endoscopic grading scores and CT volumes were significantly reduced (p < 0.0001). Comparison between groups showed significant post operative reduction in both CT volumes and in endoscopic scoring for group 2 (bulbous type) (p < 0.0001). Crushing is a simple and safe method in concha bullosa surgery. There was no recurrance in long-term outcomes. This method can be used in all types of concha bullosa effectively and provides more volume reduction in bulbous type concha bullosa.

Keywords: Computed tomography; Concha bullosa; Crushing; Endoscopy; Middle turbinate; Surgical; Treatment.