Computed Tomography Evaluation of Unilateral Chronic Maxillary Sinusitis With Osteitis

Area of Science:

• Radiology
• Otolaryngology
• Pathology

Background:

• Computed tomography (CT) is the primary noninvasive tool for evaluating osteitis in chronic sinusitis.
• While high attenuation is often associated with disease severity, sinus bone remodeling can result in both high and low attenuation.
• Limited research exists on the spread patterns of osteitis, necessitating further CT investigation.

Purpose of the Study:

• To examine bony changes in chronic maxillary sinusitis (CMS) using CT.
• To elucidate the underlying mechanisms of these bony alterations.
• To propose a comprehensive method for evaluating CMS-related osteitis.

Main Methods:

• Retrospective analysis of 45 patients with unilateral CMS and sinus wall bony changes.
• Comparison of CT findings between affected and unaffected maxillary sinus walls.
• Evaluation using a proposed method focusing on location, involvement, attenuation, and thickness.

Main Results:

• Lesions were predominantly posterior-external (88.9%), with involvement of nasal, sphenoid, palatine, and zygomatic bones.
• CT showed high attenuation in 75% and low attenuation in 25% of patients.
• Significantly different bone thickness was observed between affected and normal sides (P < .001) in both attenuation groups.

Conclusions:

• Chronic rhinosinusitis with bony changes can affect maxillary sinus walls and adjacent bones, exhibiting varied attenuation patterns.
• Both increased and decreased CT attenuation are possible in these cases.
• Detailed CT analysis of bony changes in unilateral CMS enhances diagnostic precision for osteitis.