Bilateral Concha Bullosa Research Articles

The role of using the submucosal conchoplasty technique for the management of concha bullosa in decreasing post-operative middle meatus synechia formation after functional endoscopic sinus surgery: a randomised controlled trial.

The study aimed to compare the applicability of classic lateral lamellectomy versus submucosal conchoplasty techniques in managing concha bullosa during and after functional endoscopic sinus surgery. The study randomly divided 56 patients with bilateral concha bullosa into two groups. One group of patients underwent the submucosal conchoplasty technique and the other group underwent the lateral lamellectomy technique. The study compared the intra-operative findings, including the time required for each technique, the amount of intra-operative bleeding and the post-operative endoscopic outcome of the middle meatus and middle turbinate stability. Submucosal conchoplasty was significantly more time-consuming than the lateral lamellectomy technique (p = 0.001*). The difference in the intra-operative amount of bleeding was (p = 0.086*). The lateral lamellectomy group showed a higher rate of synechia formation in the middle meatus (p = 0.012*). Submucosal conchoplasty is a valid technique for managing concha bullosa with better post-operative endoscopic outcomes.

A clinical study to compare the efficacy of crushing of middle turbinate with lateral partial turbinectomy for concha bullosa

Background: Concha bullosa (CB), a pneumatized middle turbinate is most common variations of sino-nasal anatomy. Identified in approximately ~35% (range 14-53%) of patients, a large CB cause nasal obstruction, recurrent sinus infections and headache, may develop into mucocele or mucopyocele or affect olfaction. Endoscopic lateral partial turbinectomy (LPT) is the standard procedure for the treatment of CB. However, the recurrence of contact points and postoperative synechiae with subsequent frontal recess obstruction are common complications of this technique. Crushing of a pneumatized turbinate preserves the mucosa, less time consuming and carry less risk of complications. The aim of the study was to compare the efficacy of crushing with LPT for the treatment of CB. Methods: This was a prospective cohort study conducted by convenient sampling in the Department of ENT, KIMS, Hubli, Karnataka, India. In 53 patients, 43 with unilateral and 10 with bilateral CB satisfying the inclusion and exclusion criteria were subjected to either crushing (group A) or LPT (group B). The success of both techniques were compared based on the relief of symptoms assessed by the visual analogue scale, nasal endoscopy and computed tomography (CT) scan after 6 months of surgery. Results: The overall success rate of the outcome was equal between the two groups, with no statistical (p>0.05) difference. Conclusions: Crushing the CB is as efficient as LPT for the treatment of pneumatized middle turbinate. However, surgically crushed CB can get re-pneumatization in some patients.

Multiple coexisting variations of skull and cervical spine anatomy in a symptomatic patient - uncommon or uncommonly noticed? A CT-based case study.

Among many anatomical variations of the skull and cervical spine, some may be an underlying cause of a disease, while others remain clinically silent. The estimated individual prevalences of them differ, but given the available data it is impossible to clarify how frequently they coexist with each other. The following study presents an example of seven anomalies, amongst which at least few have manifested clinically in the examined patient. A 35 y.o. Polish woman who suffered from chronic sinusitis was subjected to a computed tomography scan. Mild thickening of the anterior ethmoidal cells' mucosa, bilateral concha bullosa, paradoxical right middle turbinate, bilateral uncinate process pneumatization and arrested pneumatization of sphenoid sinus were found and addressed in context of the reported symptoms. Simultaneously other, clinically silent anatomical anomalies, were found - namely ossification of the anterior petroclinoid ligament, incomplete medial basal canal and bilateral arcuate foramen. To the best knowledge of the authors, this case report is the first to present such a coexistence of this many various anatomical anomalies, among which some played a crucial part in the chronic sinusitis experienced by the patient. Concurrence of multiple variations in the same anatomical area or functional unit may exacerbate clinical presentation of a patient. Identifying a single anomaly ought to warrant a thorough investigation into any other potentially existing variants.

THE INCIDENCE OF CONCHA BULLOSA: A RETROSPECTIVE RADIOLOGIC STUDY

Background: Middle nasal concha hypertrophy known as concha bullosa is caused by its pneumatization. Although it is the most common anatomical variation of the ostiomeatal complex, research on it in different populations is limited. It is uncertain whether concha bullosa prevalence varies across populations throughout the world.
 Objective: The purpose of study was to determine the prevalence of (superior, middle and inferior turbinate concha bullosa) in patients who visited an ENT clinic with various ENT symptoms.
 Methods: The duration of this retrospective descriptive study was six month. The study was carried out between the period from June 2022 to November 2022 at Department of ENT and Head & Neck Surgery. We examined the axial and coronal planes of patients' computed tomography (CT) scans of nose as well as paranasal sinuses who reported headaches or nasal obstruction symptoms in addition to symptoms of chronic sinusitis.
 Results: Concha bullosa was seen in 14% of the 100 scans examined. Six (42.8%) individuals had bilateral concha bullosa, whereas eight (57.1%) had unilateral concha bullosa. Out of the eight conchae, two (25%) were found on the right side while six (75%) on the left side.
 Conclusion: Study concluded that concha bullosa is the most common anatomic variation. During the preoperative evaluation, the radiologist must pay close attention to anatomical variants. It is critical for surgeons to be aware of this variation.

Computed Tomography Based Evaluation of the Anterior Group of the Paranasal Sinuses

Objective: The study aims to ascertain the prevalence of paranasal sinus variations among healthy adults in the Turkish population, as well as to analyze the symmetry of these variations. Methods: The CTIs of 200 adult patients who did not have any trauma, carcinoma, tumor, surgery, or a condition that could affect the paranasal anatomy, such as chronic rhinosinusitis, were included. The prevalences of the Agger nasi cell (ANC), supraorbital ethmoid cell (SOEC), Haller's cell (HC), middle turbinate pneumatization, and frontal sinus (FS) agenesis variations in the adult Turkish population were revealed. Results: Bilateral SOECs were found 38.5% of 200 patients, and at least 53% of patients had SOECs on one side. In 21.5% of instances, LCs were observed on both sides; in 35% of instances, they were observed on at least one side. ANCs were observed bilaterally in 68.5% of the total, the rate of patients with ANC on at least one side was 84.5%. The rate of bilaterality of the Haller cell (HC) was 24%, it was observed at least one side in 43% of the cases. Bilateral concha bullosa (CB) were observed in 19% while CB variation on at least one side was 42%. Bilateral absence of the FS was found to be 8.5%, and unilateral absence was 2.5%. Conclusion: The most common paranasal sinus variation was ANC, while the least was FS agenesis. Bilateral inheritance was found to be most prevalent in SOEC. The findings of our study hold significance for interventional procedures involving the paranasal region.

Two cases of concha bullosa in a contemporary Cypriot skeletal collection

Concha bullosa is the hypertrophy of the superior, middle, or inferior nasal conchae, most commonly referring to the pneumatisation of the middle conchae. It is considered to be the most common anatomical variant of the osteomeatal complex, rather than a pathological development. Though it is common, its aetiology is poorly understood. It is unclear whether sex or ethnicity impacts on the prevalence of concha bullosa, though some research suggests a correlation. Some researchers have argued that concha bullosa predisposes individuals to sinusitis, but the link is not consistent. In this paper, the authors present two new skeletal cases of bilateral concha bullosa identified in female individuals taken from the Cyprus Reference Research Collection (CRRC). This work aims to highlight the limitations associated with the palaeopathological diagnosis of inflammation and the interpretation of skeletal lesions that may be related to sinusitis or infection of the osteomeatal complex in archaeological bone, in relation to the presence of concha bullosa.

Do Nasal Anatomical Variations Affect the Maxillary Sinus? A CBCT Volumetric Analysis

Objective: This study aimed to determine the effect of the concha bullosa (CB) and the nasal septum deviation (NSD) on the volume of the maxillary sinuses using ITK-SNAP (http://www.itksnap.org/ download/snap/). Methods: A total of 70 CBCT scans were analyzed. Three groups were evaluated; control (absence of CB), unilateral CB, and bilateral CB. Moreover, scans were classified according to the NSD into control (no deviation), mild, moderate, and severe NSD deviation. The volume of each maxillary sinus was calculated using the ITKSNAP. Intra-observer reliability analysis was performed by paired-sample t-test. Analysis of variance ANOVA and t-test were used to compare the mean bilateral maxillary sinus volumes. Results: Intra-observer reliability for the maxillary sinus volume exhibited no significant difference for both sides (p > 0.05). The mean volume of the right and left maxillary sinuses were 12.98±4.90 cm3 and 13.18±4.99 cm3 , respectively. No significant difference between the volumes of both sides (p > 0.05) was found. The results showed no significant differences between the CB or NSD groups on both sides (p > 0.05). Conclusion: The two anatomical variations have no effect on the maxillary sinus volume. The open-source software ITK-SNAP is a valuable tool for volumetric analysis.

Multi Detector Computed Tomographical Assessment of Anatomical Variants of Paranasal Sinuses

Multi detector computed tomography (MDCT) scan of paranasal sinuses has become mandatory for all patients undergoing functional endoscopic sinus surgery. It depicts the anatomical variations in much simpler way and acts as a roadmap for endoscopic sinus surgery. In this study the maximum of participants were in the age group of 41- 50 years (32 %). The mean age of the study participants was observed to be 43.8 ± 15.6 years. HRCT PNS results shows nasal septum was found to be the most common anatomical variant (DNS- 94%). Concha Bullosa in right side were seen in 37.5% and left side were 21.9% (total unilateral cases- 59.4%) and bilateral Concha Bullosa were seen in 40.6% of the cases. Agger nasi were found to be present in 58% of the CRS cases among which right AN was 41%, left side was 30.8%, and bilateral AN were seen in 28.2% of the cases and Paradoxical Middle Turbinate were seen in 42% of cases in our study. Medialised uncinate was seen in 22% of the cases.

Prevalence of the anatomical variations of concha bullosa and its relation with sinusitis among Saudi population: a computed tomography scan study.

Concha bullosa (CB) is a pneumatic cavitation inside a concha in the nasal cavity. It is one of the most widely recognized nasal variations and is mostly found in the middle concha. CB is divided according to its site into three types; lamellar, bulbous and extensive. The goal of our study was to estimate the prevalence of CB among Saudi adult population and its association with sinusitis by using multidetector computed tomography (MDCT). This was a retrospective study carried out over a three-year period on 879 adult Saudi patients aged 18 years or older, referred for MDCT assessment of paranasal sinuses. Males were 540 and females were 339. Patients with facial congenital anomalies or nasal trauma were excluded from our study. CB was prevalent in both males and females among Saudi population (55.4%, 55.7%) respectively. Bilateral CB (55.5%) was more frequent than unilateral (44.5%). Extensive CB (44.0%) was the most frequent type. Sinusitis was associated more in patients with CB (48.0%) versus those who have no CB (5.9%). In conclusion, CB was prevalent among Saudi population and the most frequently recorded is the extensive type. Furthermore, the most common type associated with sinusitis was extensive CB (49.6%).

Bilateral concha bullosa with right sided extensive rhinolith: a case report

<p class="abstract">Anatomic variations of the paranasal sinuses can lead to various diseases per se. The paranasal sinus anatomy should be carefully examined prior to performing endoscopic sinus surgery in terms of both existent pathologies and anatomic variations. The anatomy of the paranasal sinuses and its variations have gained importance, along with advances in coronal paranasal sinus computed tomography and extensive use of endoscopic sinus surgery. Rhinolith is a mass resulting from calcification of an endogenous or exogenous nidus within the nasal cavity. It is an uncommon disease that may present asymptomatically or cause symptoms like headache and nasal obstruction. A 24 year old woman was admitted in ENT department of GGS Medical College and Hospital, Faridkot with complaints of nasal obstruction, anosmia and headache persisting for 5 years. Right sided rhinolith was detected on anterior rhinoscopy. Bilateral concha bullosa with right sided rhinolith was reported on preoperative paranasal computed tomography scan. It is known that the paranasal sinuses have a number of anatomical variations. Sometimes severe anatomic variations predispose to rhinosinusitis. Herein we report a rare case, along with a review of the literature, to emphasize that severe anatomical variations should not be ignored.</p>

Concha bullosa, nasal septal deviation, and their impacts on maxillary sinus volume among Emirati people: A cone-beam computed tomography study.

PurposeTo determine the prevalence of concha bullosa (CB) and nasal septal deviation (NSD) and their impact on maxillary sinus volume (MSV).Materials and MethodsCone-beam computed tomographic (CBCT) images of 106 Emirati people were used in this study. The direction and angle of septal deviation were calculated. The presence of CB, which could be unilateral, contralateral, or bilateral in relation to the direction of NSD, was also recorded. MSV was measured using reconstructed Digital Imaging and Communication in Medicine images on Dolphin 3D imaging software version 11.8 premium (Dolphin Imaging, Chatsworth, CA, USA). P values <0.05 were considered to indicate statistical significance.ResultsCB was detected in 37.7% of the sample; 20.7% of the sample showed single unilateral CB and 16.6% had single bilateral CB. NSD was seen in 74.5% of the sample. In the participants with CB, 45.5% showed mild deviation, 34.4% showed moderate deviation, and only 12.5% showed severe septal deviation. CB, but not NSD, was associated with significantly higher MSV on the affected side (P=0.001).ConclusionAlthough NSD was observed in more than two-thirds of the sample and CB was present in more than one-third of the sample, only CB had a significant impact on MSV.

Comparison between lateral partial turbinectomy and conchoplasty for concha bullosa

Background: pneumatization of the middle turbinate is common anatomic variations of lateral nasal wall, whereas rare in the superior and the inferior turbinate. Objective: to compare the efficacy of conchoplasty to lateral partial turbinectomy in the treatment of concha bullosa. Patients and Methods: this study included randomly selected 40 patients, who attended the ENT clinic at Al-Hussein University Hospital, Faculty of Medicine, Al-Azhar University during the period from June 2016 to November 2017.All patients have a symptomatic unilateral or bilateral concha bullosa. Patients were classified randomly into 2 groups; Group (1): 20 patients (50%) underwent lateral partial turbinectomy. Group (2): 20 patients (50%) underwent conchoplasty. Results: there was complete cure or significant reduction in severity of complaints in 15 patients (75%) who underwent LPT. In the conchoplasty group 17 patients (85%) were significantly symptoms free at the end of the follow up period. 1 case which underwent LPT developed post-operative epistaxis requiring intervention. There were no cases of epistaxis requiring intervention in the conchoplasty group. Other complications noted in the LPT group included synechiae formation in three cases (15%). Conclusion: as compared to lateral partial turbinectomy, conchoplasty is an equally effective surgery in the treatment of concha bullosa with lesser incidence of complications.

Nasal Septal Deviation and Concha Bullosa - Do They Have an Impact on Maxillary Sinus Volumes and Prevalence of Maxillary Sinusitis?

SummaryBackgroundThe aim of the study was to assess if the presence of nasal septal deviation and concha bullosa is connected with the development of sinuses and the incidence of inflammation within them.Material/MethodsWe retrospectively analysed 214 patients who underwent paranasal sinus computed tomography. There were 125 females and 89 males, the mean age being 47.67±16.74 years (range 18–97). Exclusion criteria included: age under 18 years, prior sinonasal surgery and S-shaped septum.ResultsMean volume of the right maxillary sinus was 17.794 cm3, while for the left one it was 17.713 cm3. Nasal septal deviation was found in 79.9% of computed tomography examinations and concha bullosa was observed in 42.1% of the patients’ examinations. There was an association between the presence of unilateral or dominant concha bullosa and contralateral direction of septal deviation [right-sided (p=0.039), left-sided (p=0.003)]. There was higher incidence of bilateral maxillary sinusitis in patients with septal deviation (p=0.007). Bilateral concha bullosa did not influence the incidence of bilateral maxillary sinusitis (p=0.495). Neither septal deviation (right sided: p=0.962; left-sided: p=0.731), nor unilateral/dominant concha bullosa (right: p=0.512; left: p=0,430) affected the asymmetry in volumes of maxillary sinuses. Bilateral concha bullosa was connected with larger volume of maxillary sinuses (right sinus: p=0.005; left sinus: p=0.048).ConclusionsNasal septal deviation, contrary to concha bullosa, has influence on the development of maxillary sinusitis. There is a connection between the presence of concha bullosa and direction of septal deviation. Only bilateral concha bullosa affects maxillary sinus volumes.

Significance of relationship between anatomical variants of middle turbinate and nasal septum in recurrent acute rhinosinusitis patients

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Aim of the study was to evaluate the significance of relationship between anatomical variants of middle turbinate and nasal septum, and role for the causation of recurrent acute rhinosinusitis (RARS) in a tertiary care teaching hospital.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Retrospective&lt;strong&gt; &lt;/strong&gt;analysis&lt;strong&gt; &lt;/strong&gt;of&lt;strong&gt; &lt;/strong&gt;sinonasal computerized tomography (CT) images of 160 patients with history of RARS during August 2015 to December 2016 was done for evaluation of concha bullosa (CB) and paradoxical middle turbinate (PMT) associated with deviated nasal septum (DNS). Measurements of CB, PMT and septal deviation angles were recorded. Patients with acute and expansile paranasal sinus diseases were excluded.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Of the total 160 RARS cases with DNS, 120 cases had unilateral (contralateral and ipsilateral) and bilateral (dominant and similar sized) CB, and were distributed into group I (contralateral and dominant) and group II (ipsilateral and similar sized bilateral) basing on the direction of septal convexity. Maximum transverse diameter of CB (MTDCB) and septal deviation angle values were highly significant (p =0.0001) in group I CB cases. Direction of septal convexity had no significance (58 to right and 62 to left) in relation to CB pneumatization. Septal deviation severity in group I CB cases was highly significant (p =0.0001). The fraction of 40 unilateral and bilateral PMT cases revealed no significance (p =0.45) with severity of DNS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Anatomical variants of middle turbinate associated with DNS caused increased prevalence of OMC pattern RARS. Contralateral and dominant CBs had shown relationship in direct proportion to the severity of septal deviation contributing to recurrent rhinosinusitis.&lt;/p&gt;

Study of Asssociation of Concha Bullosa with Rhinosinusitis

Introduction&#x0D; There are several studies with contradictory findings about the role of concha bullosa with predisposition to rhinosinusitis. This study was conducted to assess the relationship of osteomeatal unit blockage with concha bullosa.&#x0D; Materials and method&#x0D; A cross-sectional observational study by radiological assessment of prevalence of chronic rhinosinusitis and blockage of ipsilateral osteomeatal unit was done on 100 cases of concha bullosa detected on computed tomography to determine the prevalence of chronic rhinosinusitis in subjects with concha bullosa and to examine the latter’s relationship to osteomeatal unit blockage, which is a precursor for rhinosinusitis.&#x0D; Result&#x0D; One hundred cases of concha bullosa were studied in a total of 87 CT scan films depicting concha bullosa. Some CT scans showed unilateral concha bullosa while few scans showed bilateral concha bullosa. Ipsilateral rhinosinusitis was found in only 31% of the sides in scans of subjects with concha bullosa. Of the total 100 concha bullosae studied, extensive type was the commonest followed by bulbous and lamellar variety.&#x0D; Discussion&#x0D; Although rhinosinusitis was more predominant in the extensive type of concha bullosa compared to other types, it was statistically not significant and there was no statistically significant association between any type of concha bullosa with ipsilateral rhinosinusitis either in right side or left side.&#x0D; Conclusion&#x0D; This study has found no statistically significant association between any type of concha bullosa with rhinosinusitis. A bigger study with larger sample size is required to better assess the strength of association between concha bullosa and rhinosinusitis.

Relationships among Concha Bullosa, Nasal Septal Deviation, and Sinusitis: Retrospective Analysis of 296 Cases

We aimed to investigate the relationships among concha bullosa (CB), nasal septal deviation (NSD), and sinus disease. We retrospectively reviewed paranasal sinus computed tomography scans obtained from 296 patients-132 men and 164 women, aged 17 to 76 years (median: 39)-who had been evaluated over a 19-month period. CBs were classified as lamellar, bulbous, and extensive. In cases of bilateral CB, the larger side was designated as dominant. In all, 132 patients (44.6%) exhibited pneumatization of at least one concha, 176 (59.5%) had NSD, and 187 (63.2%) had sinus disease. Some 89 of 106 patients with unilateral or one-side-dominant CB (84.0%) had NSD, 89 of 132 patients with CB (67.4%) had sinus disease, and 109 of the 176 patients with NSD (61.9%) had sinus disease. We found a statistically significant relationship between CB and contralateral NSD, but no significant relationship between CB and sinus disease or NSD and sinus disease. While CB is a common anatomic problem that may accompany NSD, a causal relationship between CB or NSD and sinus disease is dubious.

The Potential Significance of Concha Bullosa During Nasotracheal Intubation

The authors experienced a case of severe epistaxis caused by accidental partial middle turbinectomy during nasotracheal intubation, which the patient had bilateral concha bullosa narrowing the nasal airway. Although anesthesiologist checked nasal airway through subjective symptoms and the size of both nostrils, they tend to overlook common anatomic variation, concha bullosa, and can injure turbinate structures. Therefore, preoperative computed tomography images should be carefully evaluated for the possibility of concha bullosa, which narrows nasal airway and induces the traumatic injury or epistaxis during nasotracheal intubation.

Eustachian dysfunction in chronic otitis media with bilateral concha bullosa: Is it chance finding?

Concha bullosa is reported to have a role in paranasal sinus infections. Role of asymptomatic concha bullosa in causation of Eustachian dysfunction and chronic otitis media is not well established with only few reports. Here, we report a case of a 42-year-old female patient who presented with bilateral hearing loss with no nasal complaints. On otoscopy, her tympanic membranes showed bilateral retractions with reduced mobility on the right side. Nasal endoscopy revealed incidental finding of bilateral concha bullosa confirmed on computed tomography scan of paranasal sinuses. Bilateral conchoplasty was done. In immediate postoperative period, patient had subjective as well as objective improvement in hearing status and Eustachian function. Consequently, we inferred that bilateral concha bullosa has etiological role in Eustachian dysfunction due to increased nasal resistance. Hence, conchoplasty provides immediate improvement in a dilatory function of Eustachian tube with hearing improvement.

Clinical Aspect of Concha Bullosa of Middle Turbinate and Nasal Septal Deviation

Objectives: Concha bullosa (CB) with nasal septal deviation (NSD) can be the cause of postoperative functional failure if not corrected during surgery. Methods: All the paranasal computed tomography scans (CTs) taken in a tertiary hospital from May 2011 to October 2012 were analyzed. Cases with history of nasal surgery and nasal trauma were excluded due to the possibilities of nasal anatomical changes. Results: 520 CTs were included in this study, from 550 CTs analyzed. 331 males and 189 females were included, and the ages of patients ranged from 2 to 87. 444 patients (85.38%) had NSD. The age distributions of CB were as follows: in the age group of 0~15, 0%; 16~30,.70%; 31~45, 40%; 46~60, 33.14%; and over 60 years, 25%. In 444 patients with NSD, bilateral CBs were observed in 93, unilateral CBs in wide nasal cavity in 47, and narrow nasal cavity in 7. When 269 CBs were classified as true, lamella, or bullous type, the average measured pneumatization areas were statistically wider in true type (p=0.008). When comparing the maximum pneumatization areas of CB in coronal CT of patients with NSD, the CB area of wide side nasal cavity was statistically wider than that of narrow side nasal cavity ( P = 0.000). Conclusions: CBs are clinically thought to be formed in those over 15 years old. CBs are formed mainly in wider nasal cavity, and especially larger in true type, so they should be removedin surgery.

Is pneumatization of middle turbinates compensatory or congenital?

To determine the frequency of concha bullosa (CB) and the association between the degree of pneumatization and the severity of septum deviation in both paediatric and adult groups by CT evaluation and to investigate whether the pneumatization of middle turbinates is compensatory or congenital. We retrospectively reviewed digitally stored paranasal sinus CT images of 86 paediatric and 204 adult patients. The severity of the deviation and cross-sectional area of the pneumatized area of the CB were determined using tomography images. The septums were divided into three groups according to the severity of deviation. The cross-sectional area of the contralateral side divided by the cross-sectional area of the deviation was calculated and described as the interturbinate ratio. When bilateral CB was found, the pneumatization of the CB was more prominent on the contralateral side than on the deviation side in both the paediatric and the adult groups. However, we found that the interturbinate ratios were not statistically different between the paediatric and adult groups. Also, the interturbinate ratios were independent degrees of deviation in children and adults. The frequency of CB was low in the adult group compared with the paediatric group. Interturbinate ratios were not statistically different between paediatric and adult groups and were independent of the severity of deviation. These findings suggest that the pneumatization process is not compensatory.