الفهرس 
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Abstract
Concha bullosa is the pneumatization of the concha and the most frequent variation of the sinonasal anatomy.
The concha bullosa incidence in the literature ranges from 14-53%.
The pneumatization of the middle concha devided into three groups: lamellar type is the pneumatization of the vertical lamella of the concha; bulbous type is the pneumatization of the bulbous segment, pneumatization of both the lamellar and bulbous parts is called extensive concha bullosa. The commonest type is the extensive type then the bulbous type.
Concha bullosa ostiums drain mostly to the adjacent air cells through the basal lamina, less frequently to the frontal recesses and to the hiatus semilunaris.
Sinusitis defined in our study as any evident thickening of the sinus mucosa.
We found strong correlation between the presence of a concha bullosa and sinus disease.
Sinusitis most commonly occurred in maxillary sinuses and ethmoid sinuses.
There is a strong relationship of right, left or bilateral concha bullosa compared to the presence of ipsilateral sinusitis.
We studied the importance of concha bullosa location (lamellar,bulbous and extensive) in relation with sinusitis. In lamellar CB 50% with sinusitis and 50% without sinusitis , in bulbous CB 86.7% with sinusitis and 13.3% without sinusitis , in extensive CB 94.7% with sinusitis and 5.3% without sinusitis.
The patients included in our study were symptomatic cases suspected of having sinonasal disease. Therefore the statistical interpretations of the conclusions of our study are valid only for the symptomatic population. The results should not be generalized to the whole population.
We defined nasal septal deviation as any bending of the nasal septal contour greater than 4mm from midline as evaluated on coronal CT studies.
The direction of the deviation was defined by the side of the convexity of the curvature.
We found an increased incidence of NSD broken down by convexity compared to the presence and location of unilateral or dominant if bilateral CB.
We also found that there was a strong relationship between the presence of a concha (unilateral or a dominant concha) and deviation of the nasal septal convexity away from the concha which was present in 85.4% of the cases with unilateral or a dominant concha.
We also found that septal deviation (with direction of deviation away from the site of concha bullosa) most commonly occurred with extensive pneumatization CB, than bulbous pneumatization CB and not occurred with lamellar pneumatization.
We also found, however, that there was always maintenance of the nasal air channel between the medial aspect of the concha (unilateral or dominant concha) and the adjacent surface of the nasal septum in 100% of cases.
This implies that the deviation of the septum away from the concha is not the result of the concha pushing the septum. Rather, there appears to be some as yet unknown developmental relationship between a concha and the nasal septum.
We could find no information that suggested whether the concha develops first and the nasal septum somehow “senses” the mass effect of the concha and correspondingly developed away from this side, or if the septal deviation develops first and then the concha enlarges to partially fill the expanded air channel. In either case, the septal deviation is often so great that there is compromise of the contralateral nasal air channels.
No relation was found between concha bullosa and nasolacrimal duct obstruction, 98% of CB cases has patent nasolacrimal duct.