Concha, also called turbinates, are the three pairs of shell-shaped bony structures present inside your nose which help in controlling the air which flows into your nose. 

They help moisturize and warm-up inhaled air before it goes into your lungs for respiration. Respiration is the movement of the air you breathe in and out of your lungs (breathing). 

When one of the conchae becomes filled with pockets of air, the condition is known as concha bullosa or pneumatization of the turbinate. Pneumatization means the presence of air-filled cavities. 

Let’s Learn More About Concha 

The 3 pairs of conchae are shell-shaped structures that are located on either side of your nasal septum. The nasal septum is the wall or structure that separates your nostrils or divides your nose in half. The concha is named based on their location in your nose, inferior (lowest), middle and superior (upper), and form three nasal passages for air to flow through.

  • The superior, which is the highest conchae in your nose, is located near your brain. It protects the part of the brain which helps you smell.

  • The middle sits between the superior and inferior conchae.

  • The inferior is the lowest conchae in your nose. 

Each of the nasal passages which are separated by the conchae opens into your sinus cavity. 

Your sinuses are 4 hollow air-filled sacs present in your facial bones  and are named after the bones they are present in:

  • Maxillary sinuses are located on each side of your nose, near the cheekbones.

  • Frontal sinuses are located above the eyes, near your forehead.

  • Ethmoid sinuses (3 small pairs) are located on either side of the bridge of your nose, near your eyes. 

  • Sphenoid sinuses are behind the eyes, deeper into your skull.

The main function of your sinuses is to produce mucus. Mucus is a normal, slippery, and stringy fluid in the nose that is responsible for warming, moistening and filtering the air in your nasal cavity (a large, air-filled space above and behind the nose).

Overview: Concha Bullosa

Concha bullosa means the presence of an air pocket in your middle concha. It is a very common anatomical deviation that does not always cause sinus problems except when it becomes enlarged. 

Enlarged concha bullosa may lead to a blockage that prevents your sinuses from draining properly. If there is a blockage in the drainage of the sinuses, this will lead to the accumulation of mucus and sinus infection. 

Concha bullosa may also predispose you to have a deviated septum. A deviated septum is a condition where your septum is not completely straight, making your breathing harder from one nostril.

Small conchae do not usually cause discomfort. It is the enlarged concha that may lead to pain and other associated symptoms.


A small concha bullosa will not cause any symptoms and can even go unnoticed throughout your life. However, the larger the concha bullosa, the more pain, and discomfort it will cause. The common symptoms of concha bullosa  include:

  • Pressure or pain around your sinuses and the area around your eyes.

  • Feeling like you can’t get enough air in or out of your nose.

  • Feeling that something is in the way inside your nostrils.

If there is a deviated septum, it can cause symptoms such as loud snoring, noisy breathing, nose bleeds, etc. The symptoms of concha bullosa resemble the symptoms of a sinus infection. Concha bullosa typically doesn’t cause ear and jaw pain, mucus drainage, or other associated symptoms.

Diagnosis of Concha Bullosa

You need not consult a doctor if concha bullosa isn’t affecting your ability to breathe normally. However, if your symptoms are affecting your quality of life, your doctor may suggest the following tests:

  • CT Scan. The most common imaging test done for concha bullosa. This test allows your doctor to see a cross-section of your nose and the conchae structures so that they can spot any air pockets.

  • MRI Scan. MRI images show the three-dimensional structure of your nose and the conchae.

An imaging test can help your doctor view and diagnose a possible concha bullosa and plan a treatment plan.


Treatment is not needed if your concha bullosa is not causing any pain or discomfort. Medication and/or surgery are not necessary if you do not have any symptoms.

However, if symptoms like headaches, breathing difficulties are affecting your life then your doctor may recommend surgery. Your doctor may suggest procedures mentioned below:

  • Crushing. Your doctor uses tools to squeeze the concha bullosa until they release the air that’s inside them. 

  • Turbinoplasty. Your doctor reshapes the bones and tissue around the concha bullosa to allow air to flow through the concha more easily.

  • Turbinate resection or reduction. Your doctor uses tools to remove some or all of the concha bullosa. 

  • Septoplasty. In case, you have developed concha bullosa due to deviated septum, your doctor may recommend the procedure of septoplasty. It is a surgical procedure to straighten the bone and cartilage dividing the space between your two nostrils.

Your doctor can provide you with information about your individual diagnosis and walk you through the different treatment options available to you. Not only can corrective surgery help relieve your symptoms, but it may also help prevent future complications.  

If your symptoms do not go away for more than 2 weeks, get yourself checked with an ENT specialist/physician.

Disclaimer: This article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.