Surgical Treatment of Concha Bullosa: A Comparison of the Short-term Results of Crushing and Lateral Laminectomy with and without Mucosal Preservation.

Abstract

Pneumatized middle turbinate (Concha bullosa) is one of the commonest intranasal anatomical variants. Surgery is the effective method to control symptomatic concha bullosa, however, still no clear definition for the best surgical technique. The aim of our study to assess and compare the short-term outcomes of crushing and lateral laminectomy with and without mucosal preservation in the surgical treatment of symptomatic concha bullosa. Thirty patients who underwent concha bullosa surgery (a total of 42 conchae surgeries) were included in this prospective randomized study. Patients were allocated consecutively and equally into 3 groups: Group A (lateral laminectomy without mucosal preservation, n = 10), Group B (lateral laminectomy with mucosal preservation, n = 10) and Group C (Crushing, n = 10). Patients underwent the preoperative and postoperative visual analogue score (VAS) for nasal obstruction and headache, sinonasal outcome test-22 (SNOT-22) and olfactory detection test. All patients were arranged to postoperative reevaluation for 3 months. All groups showed strong significant improvement in VAS results, SNOT-22 and smell test between preoperative and postoperative scores (P < 0.001). There was a significant difference between the three groups only upon comparing lateral laminectomy groups with crushing group. No significant differences were detected between group A and B regarding all the evaluated variables. According to our results, lateral laminectomy was more advantageous than crushing in surgical management of concha bullosa. Moreover, lateral laminectomy without mucosal preservation was as effective as lateral laminectomy with mucosal preservation and there is no detectable difference between both techniques.