Nasal Conchae

1. Overview

The nasal conchae, or turbinates, are curved, scroll-like bony projections found on the lateral walls of the nasal cavity. There are three paired conchae—superior, middle, and inferior—each covered in vascularized mucosa. Their primary role is to increase the surface area of the nasal cavity to condition inhaled air by warming, humidifying, and filtering it before it reaches the lungs.

2. Location

The nasal conchae are located within the nasal cavity, extending medially from the lateral nasal wall into the airway passage. Each concha lies above a corresponding nasal meatus, forming a distinct airflow channel:

• Superior concha: Part of the ethmoid bone; located above the superior meatus

• Middle concha: Also part of the ethmoid bone; above the middle meatus

• Inferior concha: A separate facial bone; the largest and located above the inferior meatus

3. Structure

The nasal conchae consist of thin, spongy bone covered by pseudostratified ciliated columnar epithelium (respiratory epithelium) rich in goblet cells. Key structural features include:

• Highly vascularized mucosa: Enables effective heat exchange and humidification

• Ciliated surface: Moves mucus and trapped particles toward the nasopharynx

• Turbinated shape: Increases surface area and causes turbulent airflow, enhancing air-mucosa contact

Each concha forms part of the corresponding meatus, where nearby sinuses and ducts drain.

4. Function

The nasal conchae perform multiple functions essential to respiration:

• Air filtration: Trap dust, allergens, and microbes in the mucosal lining

• Humidification: Moisturize dry air using mucus and secretions

• Thermal conditioning: Warm inhaled air via blood vessels in the mucosa

• Airflow regulation: Create turbulence to maximize mucosal exposure

5. Physiological Role(s)

The conchae support broader respiratory and immune functions, including:

• Smell facilitation: The superior concha helps direct air to the olfactory epithelium in the upper nasal cavity

• Mucociliary clearance: Cilia on the conchae help propel mucus and debris to the pharynx

• Pressure modulation: Turbulent airflow assists in regulating intranasal pressure and preventing sinus blockages

• Resonance: Contribute to voice resonance during speech

6. Clinical Significance

Inferior Turbinate Hypertrophy

Chronic inflammation (from allergies or irritants) can lead to enlargement of the inferior conchae, causing:

• Nasal obstruction

• Snoring

• Mouth breathing

Managed with nasal corticosteroids, antihistamines, or surgical reduction (turbinoplasty).

Nasal Congestion and Rhinitis

Allergic or viral rhinitis often results in conchal swelling, especially of the inferior and middle conchae, contributing to:

• Runny nose

• Itching

• Congestion

Responsive to medical therapy targeting mucosal inflammation.

Turbinate Surgery

For persistent nasal obstruction, partial resection or radiofrequency reduction of enlarged turbinates may be necessary. Care is taken to preserve mucosal function to avoid dryness or empty nose syndrome.

Concha Bullosa

An air-filled (pneumatized) middle turbinate, often asymptomatic but can compress adjacent structures or obstruct sinus drainage, leading to:

• Headache

• Recurrent sinusitis

Diagnosed via CT scan and treated surgically if symptomatic.

Deviated Nasal Septum (DNS)

A deviated septum can displace or compress the nasal conchae, especially the inferior concha, exacerbating obstruction and increasing the risk of sinus drainage issues.

Olfactory Dysfunction

If airflow is restricted to the olfactory cleft (near the superior concha), olfactory sensing may be reduced or lost—seen in nasal polyps, inflammation, or post-viral conditions like COVID-19.