Impact of Chronic Rhinosinusitis and Endoscopic Sinus Surgery on Bone Remodeling of the Paranasal Sinuses

Cho, Seok Hyun; Shin, Kyung-Hoon; Lee, Yong Seop; Jeong, Jin Hyeok; Lee, Seung Hwan; Tae, Kyung; Kim, Kyung Rae

doi:10.2500/ajr.2008.22.3222

Cited by 29 publications

(30 citation statements)

References 15 publications

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“…Bone remodeling of the paranasal sinuses can be affected by many factors including age, sex, chronic inflammation, and surgery (11). In our study group, obstruction due to NP might be the only causative factor for the obvious remodeling of the maxillary arch.…”

Section: Discussionmentioning

confidence: 77%

See 1 more Smart Citation

Modification of the maxillary bone in adults with nasal polyposis: a CT morphometric study

Serter

Günhan²,

Can³

et al. 2009

Diagn Interv Radiol

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Chronic nasal obstruction is a common complaint in otorhinolaryngology outpatient practice (1, 2). Causes of nasal obstruction, conditioning mouth breathing, include nasoseptal deviation, hypertrophied lower turbinates, adenoids and tonsils, chronic or especially allergic rhinitis, nasal trauma, congenital nasal deformities, foreign bodies, nasal polyps, and tumors (3). One of the most common causes of nasal obstruction in adults is nasal polyposis (NP) (1, 2). Computed tomography (CT) is the ideal imaging method to investigate nasal and paranasal sinus diseases (4, 5).In paranasal sinus CT scans, we have recently observed that the plane angle between the maxillary alveolar process (MAP) and palatine bone (PB) is increased and the depth of maxillary arch is decreased in many cases with NP.Pediatric orthodontics literature concerning how nasal obstruction relates to dentofacial development is extensive and whether a cause-effect relationship exists has been debated for over a century (6)(7)(8). Although recent studies suggest a relationship between chronic nasal obstruction and dentofacial deformities, many questions remain unanswered (9, 10). However, there is very limited data on the morphometry of the maxillary arch in adults with nasal obstruction.The objectives of the present study are to correlate the airway variables obtained by paranasal sinus CT findings of both patients with chronic nasal airway obstruction and a control group in adult population, and to investigate whether the bony structure of the airway is affected or not. Materials and methodsForty NP cases that were followed up by an otorhinolaryngologist at least for 1 year were included in this retrospective study. The control group consisted of 40 subjects that were randomly selected from our CT database. Control subjects had normal findings or trivial pathologies, which did not cause any nasal airway obstruction (e.g., minimal mucosal thickening, small retention cyst) reported in paranasal CT scans. Both groups were similar regarding the age and weight. The diagnosis of NP was established by direct visualization via nasal endoscopy.Paranasal sinus CT scans of all subjects were performed with the same parameters. A single slice spiral unit (Siemens Emotion, Siemens, Erlangen, Germany) was used for imaging. Unenhanced, 3 mm thick coronal and axial contiguous slices (pitch, 1.5) were obtained in the prone position with the head hyperextended. Although images were originally obtained with soft tissue and bone windows, we made the calculations on a single set of images obtained in the bone algorithm (window width, 2000-3000; window level, 400-760). The maxillary and palatine bones were evaluated on coronal images. The plane angle between MAP and There is yet no study in the literature measuring the morphometry of maxillary bone in NP. The objectives of this study are to correlate the airway variables obtained by CT findings of both chronic nasal airway obstruction and control group in an adult population, and to investigate whether the bony structur...

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Section: Discussionmentioning

confidence: 77%

“…NP is known to be associated with bronchial asthma and a number of topical and systemic diseases of different origins (11)(12)(13). The exact origin of NP is unknown.…”

Section: Discussionmentioning

confidence: 99%

Modification of the maxillary bone in adults with nasal polyposis: a CT morphometric study

Serter

Günhan²,

Can³

et al. 2009

Diagn Interv Radiol

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“…390,392 Lee et al 392 found an increased incidence of osteitis according to pathologic features in patients with CRS undergoing a revision sinus surgery (58%) compared to those with CRS undergoing primary surgery (6.7%), but did not differentiate between CRSsNP and CRSwNP patients. The estimated prevalence of osteitis in CRS patients based on radiographic criteria or histopathology is 32.5% to 79%, 399,400 which underscores the potential clinical impact of this finding.…”

Section: S55mentioning

confidence: 85%

“…Of note, previous surgery has been associated with worsened osteitis scores in several studies, suggesting osteitis may be a marker of more severe disease and/or possibly a reaction to previous surgery. 386,399,401,402 The causality and relationship of bacterial biofilms, mucosal pathology, and bacterial infection is not well understood in relationship to osteitis. Bacterial infection of the bone is an unlikely cause of osteitis in CRS patients.…”

Section: S55mentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

554

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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“…d CRSsNP, fibrotic fields: expression of type IV collagen (type IV collagen staining ×200) rather than purely subsequent to inflammation. But repeated injuries, as revision endoscopic sinus surgery (ESS) group, acting in a cumulative way, induced higher degree of tissue or bone remodeling [15].…”

Section: Real Sequence In Remodeling Features or Preferential Associamentioning

confidence: 99%

Remodeling and Repair in Rhinosinusitis

Watelet

Dogné

Mullier

2015

Curr Allergy Asthma Rep

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Remodeling refers to the development of specific but potentially irreversible structural changes in tissue. Caucasian eosinophilic chronic rhinosinusitis (CRS) with polyps associated or not with cystic fibrosis was discriminated by edema from CRS without nasal polyps, characterized by extensive fibrotic fields. However, changes in epithelial and extracellular matrix structures are common findings in all types of chronic inflammatory diseases of upper airways, but rarely specific and highly variable in extend. Recent studies have shown that remodeling in CRS appears to occur in parallel, rather than purely subsequent to inflammation. Furthermore, some preferential remodeling associations can be recognized. Tremendous efforts have been put in research on coagulation factors, cytokines, growth factors, and proteases supporting all phases of upper airway remodeling. The current exploration of other CRS sub-groups and of the particular link with concomitant asthma aims to optimize the classification of CRS and its staging modes and to develop novel therapies.

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Impact of Chronic Rhinosinusitis and Endoscopic Sinus Surgery on Bone Remodeling of the Paranasal Sinuses

Abstract: In the revision ESS group, soft tissue and bone remodeling may be greater than in the primary ESS group.

Cited by 29 publications

References 15 publications

Modification of the maxillary bone in adults with nasal polyposis: a CT morphometric study

Modification of the maxillary bone in adults with nasal polyposis: a CT morphometric study

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Remodeling and Repair in Rhinosinusitis

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