Nasal Obstruction: An Alternative to Ostiomeatal Complex Dysfunction in Sinus Disease

Abstract

We have established independent models of nasal obstruction and ostial occlusion in the same animal. Our findings suggest that ostiomeatal complex dysfunction might not be the sole underlying factor in the pathogenesis of sinus disease in all individuals. Integrity of nasal airflow seems to have a significant effect on the maintenance of the aerobic antral environment, essential to the maintenance of normal sinus function. Modulation of maxillary sinus gas composition by nasal airflow, independent of ostial patency, may be explained by the possible presence of flow-sensitive receptors in the upper respiratory tract mucosa. Work to identify such receptors is currently in progress.

Nasal Airflow, Mucociliary Clearance, and Sinus Functioning during Viral Colds: Effects of Allergic Rhinitis and Susceptibility to Recurrent Sinusitis

“…3,5 A recent animal study suggested that mere nasal obstruction without ostial occlusion plays an important role in the pathogenesis of sinus disease. 6 Computed tomography (CT) scans of adults with an early stage of common cold have demonstrated extensive pathological changes in the paranasal sinuses, indicating impaired sinus drainage and ventilation, which may increase the risk of bacterial sinusitis. 7 We have earlier shown that subjects with allergic rhinitis and susceptibility to recurrent sinusitis have impaired sinus functioning during viral colds.…”

The effects of uncinectomy and natural ostial dilatation on maxillary sinus ventilation: a clinical experimental study

“…In contrast to this study, Carenfelt and Lundberg studied pO 2 , pCO 2 and pH in purulent and non-purulent secretions from human subjects and found that mean pO 2 and pH levels were lower and pCO 2 levels higher in purulent nasal secretions when compared to nonpurulent secretions [11]. To observe the relation between ostial obstruction and maxillary sinus CO 2 level, Ganjian et al [12] analyzed a similar hypothesis in a rabbit model by blocking the maxillary sinus ostium and comparing maxillary gas composition with a control group. Their results showed that blocking the maxillary sinus ostium leads to significant increase in mean CO 2 levels when compared with the control group (7 vs. 3.58%) and they concluded that ostial occlusion causes an increase in CO 2 concentration in the maxillary sinus.…”

Impact of septoplasty alone or with endoscopic sinus surgery for treatment of chronic rhinosinusitis with deviated septum

“…This means that the use of septoplasty alone or combined with FESS in treatment of patients with CRS and deviated nasal septum gives the same outcome. Ganjian et al 1999 have established independent models of nasal obstruction and ostial occlusion in the same animal. Their findings suggested that integrity of nasal airflow seemed to have a significant effect on the maintenance of the aerobic antral environment, essential to the maintenance of normal sinus function [12].…”

“…Ganjian et al 1999 have established independent models of nasal obstruction and ostial occlusion in the same animal. Their findings suggested that integrity of nasal airflow seemed to have a significant effect on the maintenance of the aerobic antral environment, essential to the maintenance of normal sinus function [12]. Sarna et al 2002 found that severe septal deviation had been noted as a contributing factor for sinusitis [13].…”