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In , a nasal concha (; : conchae; ; for 'shell'), also called a nasal turbinate or turbinal,

(2025). 9780128118375, Elsevier.
(2025). 9780128042540, Elsevier.
is a long, narrow, curled shelf of that protrudes into the breathing passage of the in humans and various other animals. The conchae are shaped like an elongated , which gave them their name (Latin concha from Greek κόγχη). A concha is any of the scrolled spongy of the in . Anatomy of the Human Body Gray, Henry (1918) The Nasal Cavity.

In humans, the conchae divide the nasal airway into four groove-like air passages, and are responsible for forcing inhaled air to flow in a steady, regular pattern around the largest possible of . As a mucous membrane with shallow blood supply, the nasal mucosa cleans, humidifies and warms the inhaled air in preparation for the .

A rapidly dilating arteriolar circulation to these bones may lead to a sharp increase in the pressure within, in response to acute cooling of the body core. The pain from this pressure is often referred to as "brain freeze", and is frequently associated with the rapid consumption of . The shallowness of the venous blood supply of the mucosa contributes to the ease with which can occur.


Structure
Conchae are composed of pseudostratified columnar, respiratory epithelium with a thick, , and erectile tissue layer. Turbinate Dysfunction: Focus on the role of the inferior turbinates in nasal airway obstruction. S.S. Reddy, et al. Grand Rounds Presentation, UTMB, Dept. of Otolaryngology The conchae are located laterally in the nasal cavities, curling medially and downward into the nasal airway. Each pair is composed of one concha in either side of the nasal cavity, divided by the .

The superior conchae are smaller structures, connected to the middle conchae by nerve-endings, and serve to protect the . The superior conchae attach to the . The openings to the posterior ethmoidal sinuses exist under the superior meatus. The ostium exists medial to the superior turbinate.

The middle conchae are smaller but have the most complex anatomy of the nasal turbinates. They originate from the lateral edge of the of the . They insert anteriorly into the frontal process of the and posteriorly into the perpendicular plate of the . There are three mutually perpendicular segments of the middle turbinate: from proximal to distal, there is the horizontal segment (), the (), and the vertical segment (). They project downwards over the openings of the and sinuses, and act as buffers to protect the sinuses from coming in direct contact with pressurized nasal airflow. Most inhaled airflow travels between the inferior concha and the . In humans, they are usually as long as the .

The inferior conchae are the largest turbinates, can be as long as the in humans, and are responsible for the majority of airflow direction, humidification, heating, and filtering of air inhaled through the nose.

The inferior conchae are graded 1–4 based on the inferior concha classification system (known as the inferior turbinate classification system) in which the total amount of the airway space that the inferior concha takes up is estimated. Grade 1 is 0–25% of the airway, grade 2 is 26–50% of the airway, grade 3 is 51–75% of the airway and grade 4 is 76–100% of the airway.

There is sometimes a pair of supreme conchae superior to the superior conchae. When present, these usually take the form of a small crest.


Function
The conchae comprise most of the tissue of the and are required for functional respiration. They are enriched with airflow pressure and temperature-sensing nerve receptors (linked to the route, the fifth cranial nerve), allowing for tremendous erectile capabilities of and decongestion, in response to the conditions and changing needs of the body. In addition, the erectile tissue undergoes an often unnoticed cycle of partial congestion and decongestion called the . The flow of blood to the nasal mucosa in particular the venous plexus of the conchae is regulated by the pterygopalatine ganglion and heats or cools the air in the nose.

The nasopulmonary and nasothoracic regulate the mechanism of breathing through deepening of inhalation. Triggered by the flow of the air, the pressure of the air in the nose, and the quality of the air, impulses from the nasal mucosa are transmitted by the trigeminal nerve to the breathing centres in the , and the generated response is transmitted to the , the intercostal muscles, and the diaphragm.

The conchae are also responsible for filtration, heating, and humidification of air inhaled through the nose. Of these three, filtration is achieved mostly by other more effective means such as mucus and cilia. As air passes over the conchae, it is heated to 32–34 °C (89–93 °F), humidified (up to 98% ) and filtered.


Immunological role
The respiratory epithelium that covers the erectile tissue (or ) of the conchae plays a major role in the body's first line of defense. The respiratory epithelium is partially composed of -producing . This secreted mucus covers the nasal cavities, and serves as a filter, by trapping air-borne particles larger than 2 to 3 . The respiratory epithelium also serves as a means of access for the , which protects the body from being infected by viruses or bacteria.


Smell
The conchae provide, first and foremost, the humidity needed to preserve the delicate olfactory epithelium, which in turn is needed to keep the olfactory receptors healthy and alert. If the epithelial layer gets dry or irritated, it may cease to function. This is usually a temporary condition but, over time, may lead to chronic . The turbinates also increase the of the inside of the nose, and, by directing and deflecting airflow across the maximum mucosal surface of the inner nose, they are able to propel the inspired air. This, coupled with the humidity and filtration provided by the conchae, helps to carry more scent molecules towards the higher, and very narrow regions of the nasal airways, where olfaction nerve receptors are located.

The superior conchae completely cover and protect the nerve axons piercing through the (a porous bone plate that separates the nose from the brain) into the nose. Some areas of the middle conchae are also by the olfactory bulb. All three pairs of conchae are innervated by and receptors, via the (or, the fifth ). Research has shown that there is a strong connection between these nerve endings and activation of the olfactory receptors, but science has yet to fully explain this interaction.


Clinical significance

Dysfunction
Large, swollen conchae, often referred to clinically as turbinates, may lead to blockage of nasal breathing. , exposure to environmental , or a persistent within the sinuses can lead to turbinate swelling. Deformity of the can also result in enlarged turbinates. Reduction/Removal of the Inferior Turbinate From the Sinus Info Center.

Treatment of the underlying allergy or irritant may reduce turbinate swelling. In cases that do not resolve, or for treatment of , turbinate surgery may be required.


Surgery
Turbinate reduction is a surgery to reduce the size of the turbinates (typically inferior turbinates). There are different techniques, including bipolar radiofrequency ablation (also known as ), , and use of cold steel instruments (e.g. microdebrider).

In the case of turbinate reduction, only small amounts of turbinate tissue are removed because the turbinates are essential for respiration. Turbinectomy is usually reserved for patients who have persistent symptoms despite previous turbinate reduction surgery. Risks of reduction of the inferior or middle turbinates include empty nose syndrome. As Steven M. Houser suggested, "this is especially true in cases of anterior inferior turbinate (IT) resection because of its important role in the internal nasal valve."Houser SM. Surgical Treatment for Empty Nose Syndrome. Archives of Otolaryngology Head & Neck Surgery\ Vol 133 (No.9) Sep' 2007: 858–863.

is an abnormal pneumatization of the middle turbinate, which may interfere with normal ventilation of the and can result in recurrent . In some cases, the concha bullosa may be resected to help resolve persistent symptoms.


Animals
Generally, in animals, nasal conchae are convoluted structures of thin bone or cartilage located in the . These are lined with that can perform two functions. They can improve the sense of smell by increasing the area available to absorb airborne chemicals, and they can warm and moisten inhaled air, and extract heat and moisture from exhaled air to prevent of the lungs. turbinates are found in all living , and turbinates are found in most mammals and birds.

Animals with respiratory turbinates can breathe faster without drying out their lungs, and consequently can have a faster metabolism. For example, when the exhales, its nasal turbinates condense moisture from the air and absorbs it for reuse. and other possess well-developed nasal turbinates.Wang (2008) p. 88. These turbinates allow for heat exchange between small arteries and veins on their (turbinates positioned on bone) surfaces in a counter-current heat-exchange system. Dogs are capable of prolonged chases, in contrast to the ambush predation of cats, and these complex turbinates play an important role in enabling this (cats only possess a much smaller and less-developed set of nasal turbinates). This same complex turbinate structure help conserve water in arid environments.Wang (2008) p. 87. The water conservation and thermoregulatory capabilities of these well-developed turbinates in dogs may have been crucial adaptations that allowed dogs (including both domestic dogs and their wild prehistoric ancestors) to survive in the harsh environment and other cold areas of northern Eurasia and North America, which are both very dry and very cold.

and more primitive have olfactory turbinates that are involved in sensing smell rather than preventing desiccation. While the maxilloturbinates of mammals are located in the path of airflow to collect moisture, sensory turbinates in both mammals and reptiles are positioned farther back and above the nasal passage, away from the flow of air. has ridges positioned low in the nasal cavity, indicating that it had maxilloturbinates that were in the direct path of airflow. The maxilloturbinates may not have been preserved because they were either very thin or . The possibility has also been raised that these ridges are associated with an olfactory rather than turbinates. Nonetheless, the possible presence of maxilloturbinates suggests that Glanosuchus may have been able to rapidly breathe without drying out the nasal passage, and therefore could have been an endotherm.

The bones of nasal turbinates are very fragile and seldom survive as fossils. In particular none have been found in fossil birds. But there is indirect evidence for their presence in some fossils. Rudimentary ridges like those that support respiratory turbinates have been found in advanced Triassic , such as and . This suggests that they may have had fairly high metabolic rates.

(1982). 9780124041202, Academic Press.
The paleontologist and others have argued that no evidence of nasal turbinates has been found in dinosaurs. All the dinosaurs they examined had nasal passages that they claimed were too narrow and too short to accommodate nasal turbinates, so dinosaurs could not have sustained the breathing rate required for a mammal-like or bird-like metabolic rate while at rest, because their lungs would have dried out. However, objections have been raised against this argument. Nasal turbinates are absent or very small in some birds, such as , Procellariiformes and . They are also absent or very small in some mammals, such as anteaters, bats, elephants, whales and most primates, although these animals are fully endothermic and in some cases very active.
(1971). 9783805511933
Furthermore, ossified turbinate bones have been identified in the dinosaur .


See also
==Additional images==


Notes

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