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Inicio Acta Otorrinolaringológica Española Concha bullosa. A radiological study and a new classification
Journal Information
Vol. 70. Issue 3.
Pages 145-150 (May - June 2019)
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Vol. 70. Issue 3.
Pages 145-150 (May - June 2019)
Original article
Concha bullosa. A radiological study and a new classification
Cornete medio bulloso. Un estudio radiológico y una nueva clasificación
Christian Calvo-Henríqueza,
Corresponding author
, Xenia Mota-Rojasa, Alberto Ruano-Ravinab,c, Gabriel Martinez-Capoccionia, Kaelon Lattomusd, Carlos Martin-Martina,e
a Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Spain
b Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain
c CIBER de Epidemiología y Salud Pública, CIBERESP, Spain
d College of Medicine, University of Arizona, United States
e Department of Otolaryngology, University of Santiago de Compostela, Spain
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Figures (2)
Tables (2)
Table 1. Description of the sample.
Table 2. Description of the sample: patients with chronic rhinosinusitis without nasal polyps.
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A pneumatised middle turbinate is called concha bullosa. It has been classified according to its extension in the coronal plane. We propose the first classification according to the axial extension of pneumatisation of the middle turbinate.

Material and methods

Bulbous concha bullosa was classified in six categories according to the degree of pneumatisation of the body of the middle turbinate in the axial plane.


196 CT sinonasal scans were included. 28.06% of patients had concha bullosa, unilateral in 13.26% and bilateral in 14.79%. The most common concha bullosa found was type I, followed by type III, II, IV and V. There were no statistically significant differences by side, between the patients with or without chronic rhinosinusitis without polyps.


Our results support the hypothesis that concha bullosa is not related to chronic rhinosinusitis. Furthermore, type IV and V cells mean posterior aeration of the middle turbinate. Those variations are rare and posterior, so they can easily pass unnoticed during endoscopic sinus surgery. Our classification is also important as a surgical reference, and it can be easily studied on the preoperative CT scan.

Concha bullosa
Paranasal Sinuses
Middle Turbinate
Ethmoid sinus

El cornete medio bulloso se define como una neumatización del cornete medio. Ha sido clasificado de acuerdo a la extensión de la neumatización en el plano coronal. En este trabajo proponemos la primera clasificación de acuerdo a la extensión de la neumatización en el plano axial.

Material y métodos

La concha bullosa bulbar se clasificó en 6 variantes de acuerdo al grado de neumatización del cuerpo del cornete medio en el plano axial.


Se incluyeron 196 TC nasosinusales. Se encontró una concha bullosa bulbar en el 28,06% de los pacientes, unilateral en el 13,26% y bilateral en el 14,79%. La variante más frecuente fue la tipo i, seguida de las tipo iii, ii, iv y v. No se encontraron diferencias estadísticamente significativas por lado. Tampoco se encontraron diferencias estadísticamente significativas al comparar subgrupos de pacientes con y sin rinosinusitis crónica sin pólipos.


Nuestros resultados sustentan la hipótesis de que el cornete medio bulloso no es causa de rinosinusitis crónica. Por otra parte, las celda tipo iv y v implican una neumatización posterior del cornete medio. Estas variantes son raras, y posteriores, de modo que pueden pasar fácilmente desapercibidas durante la cirugía endoscópica. Asimismo, esta clasificación es importante como referencia quirúrgica que puede estudiarse con facilidad en el estudio preoperatorio de la TC nasosinusal.

Palabras clave:
Cornete medio bulloso
Senos paranasales
Cornete medio
Seno etmoidal


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