Should I go ahead w/ septum surgery/inferior turbinate reduction without reducing concha bullosa of middle turbinates? (Photos)

My ENT doctor has recomended sugery for my deviated septum/ nasal spur and inferior turbinate reduction. She does not want to do surgery on my middle turbinate concha bullosa. I suffer from congestion and have only had one bad case of sinus infection. The concha bullosa appears very large in the left middle turbinate. I have no known allergies, but am seeing an allergist in a few weeks.

Doctor Answers 5

Deviated septum, enlarged turbinates and concha bullosa

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Based on your CT scan, you have deivated septum, a large left middle turbinate concha bullosa, as well as a large bone spur and large turbinates.

These conditions can be safely corrected by septoplasty, turbinoplasty, and endoscopic removal of concha bullosa. Commonly patients are very happy with the significant improvement of their symptoms. 

In our office we provide patients with a personalized, and individualized consultation to address these similar issues.    

Best wishes and good luck,

Dr. Sajjadian,

Triple board certified surgeon

Turbinate reduction

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I often perform inferior turbinate reduction and it works very well.  I have not performed reduction of the middle or concha bullosa and feel that inferior Turbinectomy and septoplasty should be sufficient for breathing.

Concha bullosa and septoplasty

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The concha bullosa is large and is most likely contributing to your nasal obstruction.  It should be addressed at the time of your septal surgery.  The concha can be resected whilst maintaining a middle turbinate.  Best wishes. 

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 16 reviews

septoplasty, turbinate surgery, and concha bullosa resection

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From the limited CAT scan views, it appears that there is a significant deviated septum with a bone spur, turbinate hypertrophy and concha bullosa.  The concha bullosa on the patient's left side is large enough that it can be causing nasal obstruction and should be reduced.  Reducing the concha bullosa is a very straightforward and easy procedure by a board certified ENT/ facial plastic surgeon 

Concha Bullosa Recommendations

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Thanks for your post. Your CT Scan shows a large left middle turbinate concha bullosa, deviated nasal septum to the right with a large bone spur and enlarged turbinates. From these limited views your sinuses are relatively clear, consistent with only mild sinus symptoms. In my view, I would consider an endoscopic concha bullosa reduction while you are having your septoplasty and turbinate procedure. A conservative, vertical division conchoplasty with preservation of the medial/superior turbinate would be my choice. This improves your nasal airway and respects the natural anatomy to avoid overreaction of the concha bullosa. Given the size and location of the concha bullosa, leaving it alone may result in persistent nasal obstructive symptoms. Ask your physician to re-visit this issue and consider another opinion should you need confirmation. Best wishes. 

Fred J. Bressler, MD, FACS
Houston Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.