What Is Concha Bullosa And How Is It Managed?
Concha bullosa is a type of ayurveda medicine used to treat various ailments including colds, flu, cough, asthma, bronchitis and other respiratory diseases. Concha bullosa is also known as lamellar concha bullosa or chakrasana. Its origin lies in India where it was developed over centuries by Ayurvedic practitioners.
The word “bull” comes from the Hindi word “bhuj”. The term refers to the large number of small hollow bones in the body. These are called chakras and they control many vital functions such as breathing, digestion, circulation and sexual function.
In Indian culture, bulls have been revered since ancient times. They were believed to possess magical powers that could protect their owners against harm. Hence, bulls were often sacrificed to appease gods.
Ayurveda is a branch of traditional Indian medicine which uses herbs and plants to treat disease. Ayurveda treats symptoms rather than cures them. The term “medicine” does not refer only to drugs but also includes natural remedies, homeopathic preparations and even dietary supplements.
The word “concha” means circle in Spanish and concha bullosa literally translates into “circle of bull’s horns”.
The term lamellar describes the structure of the bones. Lamellar bones are formed by a thin sheet of bone covered by an outer layer of cortical bone.
Concha bullosa is used in the ear to treat hearing and balance problems. It works by vibrating with sound wave and sending them to the inner ear where they are interpreted as sound. If concha bullosa is absent or damaged, the person will suffer from hearing problems.
Concha bullosa can also be found in the nose where it helps to warm and moisten air when one breathes in. It works in a similar way as the eardrum, namely by vibrating with each breath and sending sound waves into the inner ear where they are interpreted as sound.
Concha bullosa surgery can be painful but most patients experience relief and improved quality of life following the operation.
Concha bullosa surgery cost can vary greatly from one patient to another. Age, medical history and other factors such as medications that the patient may be taking will affect the final cost of the procedure.
The surgery involves cutting open the skin and placing the bones back into position where they can heal. Sometimes a strong adhesive or stitches may be used to keep the bones in place while they heal.
Concha bullosa surgery recovery time varies with the patient. Most people can return home on the same day as their operation or the next day at the latest. Patients are warned not to drink alcohol for at least a month after the procedure due to the risk of bleeding.
The most common complication of concha bullosa surgery is infection but this can usually be treated with antibiotics. Other serious complications such as nerve damage during surgery and excessive bleeding may also occur.
Major and minor complications tend to increase with age which is why patients are advised to seek treatment before the condition deteriorates.
Concha bullosa surgery restores hearing and balance in most patients. The condition is congenital which means that it has been present since birth and there is usually no history of trauma or injury to the ear.
The bones in the middle ear are known as ossicles. These are smallest bones in the human body. The smallest one, the stirrup, is so small that it has a diameter of only 0.9mm.
The stirrup acts as a lever, moving with the eardrum and transferring vibrations from the eardrum into the inner ear. The stirrup bone is so-called because it resembles a stirrup.
There are two bones behind the stirrup called the inner and outer malleus (or hammer). The inner malleus attaches to the tympanic membrane or eardrum while the outer malleus attaches to the inner edge of the stirrup. These two bones act like a lever, moving with the eardrum and transferring vibrations to the inner ear.
The final ossicle in this chain is known as the incus (or anvil). The incus is shaped like an anvil and sits directly behind the stirrup. It is held in place by a membrane called the oval window. The oval window allows vibrations from the incus to be transferred into the cochlea, which is located within the inner ear.
The main difference between concha bullosa and otosclerosis is that conchal bullosa affects the middle ear while otosclerosis affects the inner ear. The cause of otosclerosis is not known but it is believed to be related to age, with most patients developing the condition after the age of 40.
The cochlea is the part of the inner ear that translates sound waves into signals that are sent to the brain so that we can hear. The cochlea has a distinctive C-shape and is divided into three sections called the scalae, with each section containing rows of tiny sensory cells called hairs.
Sound pushes on the hairs in the cochlea, causing them to move and sending signals to the brain.
More severe cases of otosclerosis can cause a gradual hardening of the scalae and a loss of sensory cells. This hardening of the scalae is known as ossification or bonyisation of the cochlea and causes a permanent hearing loss.
In some cases, the sound is no longer transferred correctly from the middle ear to the inner ear. This may cause a ringing or buzzing noise known as tinnitus. The patient may also experience dizziness or vertigo caused by a problem with the balance organs in the inner ear.
Diagnosing otosclerosis will usually involve a hearing and balance test using an instrument called an audiometer. A high-pitched squeal is used to test hearing while the patient is asked to keep their head still and not move.
This test should be repeated in a quiet environment and in a noisy environment. It can help identify patients who have an abnormality in the inner ear that affects their hearing.
Concha bullosa is a congenital condition where the bones of the middle ear do not fully form during fetal development. It will usually be diagnosed using a combination of medical and family history plus a physical examination. An imaging test such as an X-ray, CT scan or MRI scan may be used to confirm the diagnosis.
Treatment options for otosclerosis are split into three categories: observation, surgery or hearing aids. Patients who have otosclerosis but do not currently experience any symptoms may be advised to simply observe and repeat regular checkups with their doctor. This will enable them to catch any further signs of the condition in its early stages.
Surgery is the main treatment for patients with otosclerosis who also experience a hearing loss or dizziness. The aim of surgery is to remove the hardened bone inside the middle ear and replace it with a man-made material. This procedure is called a stapedectomy.
Hearing aids are often used to help patients with otosclerosis that have a mild hearing loss.
The outlook for otosclerosis is good with most patients experiencing a full recovery after surgery.
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Source: Diseases Database
Otosclerosis
Sources & references used in this article:
Concha Bullosa Affects Baseline and Postoperative Quality-of-Life Measures in Surgically Managed Chronic Rhinosinusitis by JR Qualliotine, A Jafari, S Shen… – American Journal of …, 2020 – journals.sagepub.com
Concha bullosa mucocele and mucopyocele: a series of 4 cases by KH Al-Sebeih, MH Bu-Abbas – Ear, Nose & Throat Journal, 2014 – journals.sagepub.com
Giant cell reparative granuloma of the concha bullosa by CB Koay, HB Whittet, RM Ryan… – The Journal of …, 1995 – cambridge.org
Isolated turbinitis and pneumatization of the concha inferior in a child by AF Kiroglu, H Cankaya, K Yuca, T Kara… – American journal of …, 2007 – Elsevier
A concha bullosa crusher for use in endoscopic sinus surgery by TJ Woolford, NS Jones – The Journal of Laryngology & Otology, 2000 – cambridge.org
Clinical benefits of surgical management of concha bullosa by KS Mehta, A Yousuf, IA Wazir… – International Journal of …, 2017 – researchgate.net
Effect of turbinoplasty in concha bullosa induced rhinogenic headache, a randomized clinical trial by ME Yarmohammadi, H Ghasemi… – Journal of research in …, 2012 – ncbi.nlm.nih.gov
Concha bullosa: CT evaluation by SJ Zinreich, DE Mattox, DW Kennedy… – Journal of computer …, 1988 – journals.lww.com
