Bone Changes in Chronic Rhinosinusitis: Pathological or Physiological?

Bone remodelling is a normal physiological process which occurs in all bones. Hence bone changes should also be detected in undiseased or minimally diseased ethmoids as well as in chronic rhinosinusitis (CRS) patients. To test this hypothesis, we compared ethmoid bone histology between two groups of...

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Bibliographic Details
Published in:Indian journal of otolaryngology, and head, and neck surgery and head, and neck surgery, 2022-06, Vol.74 (2), p.178-184
Main Authors: Pokharel, Monika, Khadilkar, Meera Niranjan, Sreedharan, Suja, Pai, Radha, Shenoy, Vijendra, Bhojwani, Kiran, Alva, Arathi, Zubair, Sabah Mohd
Format: Article
Language:English
Subjects:
Bones
Endoscopy
Head and Neck Surgery
Histopathology
Medicine
Medicine & Public Health
Original
Original Article
Otorhinolaryngology
Physiology
Rhinitis
Sinusitis
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Summary:Bone remodelling is a normal physiological process which occurs in all bones. Hence bone changes should also be detected in undiseased or minimally diseased ethmoids as well as in chronic rhinosinusitis (CRS) patients. To test this hypothesis, we compared ethmoid bone histology between two groups of patients; a study group of CRS patients and a group of patients whose radiological, endoscopic and symptom scores were significantly less when compared to the CRS group. The study group had 75 patients who underwent functional endoscopic sinus surgery for CRS. The control group included 16 patients who had significantly different endoscopic and radiological scores from the study group. On histopathology, the bone harvested from the ethmoid sinuses were grouped as no remodelling activity (Score 1), mild activity (Score 2) and marked activity (Score 3). Thirty-six percent of patients in the study group and 37.5% of patients in the control group had Score 2 and 3 bone changes and the difference was not statistically significant (χ 2  = 1.824, p  = 0.402). Correlation of bone changes in CRS done with parameters like Lund–Mackay radiological, surgical and symptom scores and Lund–Kennedy endoscopic scores showed no statistical significance. Similar bone changes were detected in CRS patients and the control group. The bone changes seen in histopathology in CRS patients could partly be due to the normal physiological remodelling occurring in all bones.
ISSN:2231-3796
0973-7707
DOI:10.1007/s12070-020-02076-5