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Bone Changes in Chronic Rhinosinusitis: Pathological or Physiological?

Monika Pokharel1,2, Meera Niranjan Khadilkar1, Suja Sreedharan1

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Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|July 11, 2022
PubMed
Summary

Bone remodelling occurs in healthy and chronic rhinosinusitis (CRS) patients. Histopathology revealed similar bone changes in both groups, suggesting physiological remodelling contributes to ethmoid bone alterations.

Keywords:
Bone remodellingChronic rhinosinusitisDisease severityEndoscopyEthmoid bone

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Area of Science:

  • Otolaryngology
  • Pathology
  • Bone Biology

Background:

  • Bone remodelling is a continuous physiological process affecting all bones.
  • Understanding ethmoid bone changes in chronic rhinosinusitis (CRS) is crucial for diagnosis and treatment.
  • Previous studies have not fully elucidated the role of physiological bone remodelling in CRS.

Purpose of the Study:

  • To compare ethmoid bone histology between patients with chronic rhinosinusitis (CRS) and a control group with minimal sinonasal disease.
  • To investigate the correlation between bone remodelling activity and clinical parameters in CRS.

Main Methods:

  • Histopathological analysis of ethmoid bone samples from 75 CRS patients and 16 controls.
  • Scoring of bone remodelling activity (Score 1: no activity, Score 2: mild, Score 3: marked).
  • Correlation analysis with Lund-Mackay radiological, Lund-Kennedy endoscopic, and symptom scores.

Main Results:

  • No statistically significant difference in bone remodelling activity (Scores 2 and 3) between CRS patients (36%) and controls (37.5%).
  • Bone remodelling scores did not correlate significantly with radiological, endoscopic, or symptom scores in CRS patients.
  • Similar bone changes observed in both CRS and control groups.

Conclusions:

  • Ethmoid bone changes observed in chronic rhinosinusitis (CRS) patients are comparable to those in individuals without significant sinonasal disease.
  • Physiological bone remodelling likely contributes to the observed bone alterations in the ethmoid sinuses.
  • These findings suggest that bone changes in CRS may not solely be indicative of disease activity.