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Endoscopic Excision of Concha Bullosa

Adam Johnson, Gresham Richter·Arkansas Children's Hospital·Mar 15, 2016·2,683 views

Contributors: Gresham Richter

Here we present endoscopic excision of a concha bullosa (a pneumatized middle turbinate) that was causing obstruction in the left nasal cavity.  This particular patient failed medical management of his chronic sinusitis including antibiotic and steroid therapy. The concha bullosa was causing obstruction of the maxillary sinus ostium and deviation of the nasal septum. Resection of the concha bullosa was necessary in order to complete a functional endoscopic sinus surgery afterward and septoplasty (not shown).

DOI # 10.17797/pyzfxehca8

Author Recruited by: Gresham Ritcher

The concha bullosa was excised using Afrin and 1% lidocaine with 1:100,000 epinephrine for local anesthesia and to help with hemostasis. The concha bullosa is incised with a freer and the lateral portion is removed with a through-cut instrument and microdebrider.
Nasal obstruction, poor visualization during FESS or septoplasty.
None.
Microdebrider, Zero degree operating endoscope.
CT sinus.
Left = septum; right inferior turbinate; middle of the screen = middle turbinate/concha bullosa.
Disadvantage: can lateralize and occlude the middle meatus; Advantage: provides exposure and can be used to treat sinus associated headaches.
Bleeding
Bleeding
N/A
N/A

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