Middle nasal concha is an anatomical component of the ethmoid bone, which is the most important reference during endoscopic interventions on the paranasal sinuses, as well as a structure that affects the middle nasal passage aerodynamics. Many practitioners take the view in their work that there is an inextricable connection between pathological changes of the middle nasal concha and risk of developing chronic sinusitis. This in turn determines its resection options, including in the case of bullous transformation. This literature review reveals that, despite the significant prevalence of bullous hypertrophy in patients with chronic sinusitis, none of the analyzed studies could reliably prove a direct relationship of changes in the middle nasal concha and development of chronic sinusitis. Partial resection of the middle nasal concha is a uniform solution if intraoperative correction is needed. This approach ensures the preservation of an important anatomical reference for subsequent interventions and contributes to reduction of the risk of such long-term complications of endoscopic sinus surgery as formation of the synechias, the nasofrontal pocket strictures and cicatrization of the ethmoid corridor.