Osteitis in chronic rhinosinusitis with nasal polyps: a comparative study between primary and recurrent cases

Reports in rhinology suggest that operated cases of chronic hypertrophic rhinitis with nasal polyps are more prone to further recurrence. This study was designed to find out if recurrence rate after surgery is related to a possible increase in the incidence and degree of osteitis. A prospective study of 82 patients with nasal polyps was carried out. They were divided into two groups: group A 50 patients, undergoing FESS for the first time, group B 32 patients, undergoing revision surgery. Histopathological examination was performed for specimens taken from the bony septa of the ethmoid with the overlying mucosa. Bony changes were seen in only 30% of the patients in group A, compared to 87.5% in group B; this difference was statistically highly significant (p = 0.001). Failure was seen in five patients (10%) in group A, 26.6% had osteitis. In contrast, failure was seen in 53% of group B, and constituted 60.7% of patients with osteitis in this group. Surgery plays a major role in increasing the incidence of osteitis in patients with nasal polyps. The increase recurrence rate in revision cases is not only related to osteitis. There are other factors than osteitis which needs further studies.