The middle part of the nose consisting of cartilage and bone, which divides the nasal cavity into two parts as right and left, is called Septum.
Nasal flesh or concha (turbinate) is a structure consisting of bone and soft tissue, extending in the half C form from the outer wall of the nose towards the septum located in the mid-center line. They usually exist as 3, sometimes 4 parts in each of the right and left parts. They are called the lower, middle and upper concha. In parallel with the structure of the nose, the lowest concha is the largest and the uppermost concha is the smallest. Concha is not adenoid as it is mistakenly known by the public; it has a different structure, location and function.
The conchas are vital for many functions that the nose performs. The function of the conchas is to slow down the speed of the air inhaled through the nose, to make the air ready to enter the lung by heating it up to about 25°C, to moisten and clean it from foreign substances and particles and to produce some enzymes.
They expand and shrink from time to time depending on the blood circulation in order to function and protect the lungs while breathing. Thus, the airways are no longer stable and acquire a controllable dynamic structure that adapts to external factors.
The growth and shrinkage serving for the cilia, which protects the lungs from dirt, dust, viruses, bacteria and toxins and to filter the air, not to dry and remain moist, is commanded by both nasal cavities non-simultaneously, but in turn and in shifts. This shift, ranging from 30 minutes to 6 hours, is called nasal cycle. Individuals do not understand such difference, as the total amount of air inhaled does not change. During the nasal cycle, one nasal cavity, or air channel, starts to rest the nasal hair by passing very little air with the swelling of the concha, while the other one allows normal air flow.
Besides resting and keeping the nasal hair moist, another function of the nasal cycle is to ensure good smell. Smelling is related to the chemicals in the air we breathe. Some chemicals need to stay in the olfactory (receptor) longer for their scent to be recognized. The smell of the chemicals in the slow moving air during the nasal cycle is better perceived in the closed nasal cavity with less airflow.
Recent studies have argued that the nasal cycle has an effect even in psychological diseases such as Bipolar Disorder and Schizophrenia.
Sometimes structural disorders such as abnormal swelling and growth occur in the bone and/or soft tissue of the conchas, which fulfill nasal functions and have a sensitive structure. These growths are called Concha Hypertrophy (Nasal Flesh Growth - Turbinate Hypertrophy). The mentioned growth is mostly seen in the lower concha and rarely in the middle concha.
Lower concha growth occurs due to the curvatures in the septum (septum deviation) as a result of allergies or nasal trauma. Except for very rare cases, it is uncommon in children. Sometimes pregnancy, hormonal diseases and medications become effective factors for lower concha growth.
Inflammation in the concha tissues of people with allergy causes edema formation in these tissues, vasodilation and blood build up, causing the concha to grow.
Since the space on the opposite side of the nasal cavity, where the curvature in the septum tends to curve in people with deviation will expand, the concha tends to narrow this expansion to control the airway and maintain normal air flow. This growth is called Compensatory Hypertrophy.
Hormonal changes in women during pregnancy and diseases such as sinusitis, thyroid gland diseases, diabetes or excessive hormone production can also cause blood build-up and edema in the concha, resulting in turbinate growth.
The air cells forming the sinuses, which are a different structure in the nose, may be located unfamiliarly in the bone structure that forms the inner part of the middle concha. Formation of air bubbles in this bone is called concha bullosa and causes the middle concha to grow and close the airway.
The biggest complaint of people with concha hypertrophy is nasal obstruction. This is because the concha enlarges and narrows the airway, so the nose cannot provide the necessary amount of air for the body. Air that is necessary for the respiratory system and cannot be attained due to nasal obstruction is taken orally. Since there is not any structure in the mouth area to compensate for the functions of nasal hair and nasal flesh, the air taken orally is dry and dusty, causing dry mouth and lung infections due to dust ingestion. Since the conchas that grow in a horizontal position in fact will grow too much with the effect of concha growth cause snoring, reduce sleep quality, and cause fatigue and exhaustion. Difficulties are experienced in sports requiring excessive effort or in labor-intensive activities.
Concha hypertrophy causes ache in the face and forehead area, especially in the sinus areas, as it affects the course of air flow.
Dirt, dust, viruses, bacteria and toxins that enter the body also cause frequent allergic reactions. Along with allergic problems, secondary disorders such as itchy nose and nasal discharge, watering and itching of eye, and sneezing occur; and this negatively affects the quality of life.
Conchas, with impaired structure, cause the odors to be perceived incorrectly or not be perceived.
When the concha bullosa occurring in the middle conchas progresses, it causes narrowing of the canal entrances where the sinuses expand to the nasal cavity and sinusitis.
Hypertrophy occurring in the lower concha manifests as soft tissue growth, bone growth or the growth of both structures in the concha. Detecting the right area of the growth ensures selection of the right treatment method.
For diagnosis, intranasal examination of the patient showing the symptoms of Concha Hypertrophy is performed painlessly with help of physical, radiographic imagin