Bone Involvement in Sinusitis: An Apparent Pathway for the Spread of Disease

Abstract

Objectives/Hypothesis: To study the effects of bone involvement in experimentally induced sinusitis and the effect of involved bone on the overlying mucosa. Study Design: Animal study. Methods: Sinusitis was induced unilaterally with Pseudomonas aeruginosa in the maxillary sinus of 19 New Zealand white rabbits. At 6 weeks, the pathogenic organism was confirmed by culture, and a segment of the bone from the medial wall of the sinus implanted in a submucosal pocket in the opposite sinus. The rabbits were killed at predetermined time intervals up to 13 weeks from sinusitis induction, and en bloc sinus sections were decalcified and stained. Results: The implanted bone reabsorbed partially or totally in all specimens. However, the study revealed clear histological evidence of bone involvement adjacent to the infected sinuses and the bony changes extended to the noninfected side in all specimens. The histological findings were identical to those seen in chronic osteomyelitis. Conclusions: This study demonstrates the ability for pseudomonal sinusitis, at least in the presence of surgical intervention, to involve bone at a distance from the site of primary infection in the absence of intervening mucosal disease. If confirmed with additional organisms and models, these findings have significant implications for the therapeutic management of chronic sinus disease.

Microbiological study of role of fungi in primary atrophic rhinitis

“…12 Chronic osteomyelitis accounts for the bone loss seen in primary atrophic rhinitis; furthermore, it contributes to the persistence of the neighbouring mucosal disease. 13,14 . This study undertook microbiological analysis of crusts and secretions obtained from 14 patients with primary atrophic rhinitis .…”

Endoscopic sinus surgery: evolution and technical innovations

“…In addition, the inflammation can ENDOSCOPIC SINUS SURGERY: EVOLUTION AND TECHNICAL INNOVATIONS spread, through the bone, a significant distance away from the primary site of infection. 10 Although organisms have not been identified within the bone, there appears little doubt that these bony changes are a significant factor in the disease's poor response to medical therapy alone. More recent evidence has examined the role of bacterial superantigens and biofilms as exacerbating factors in this disease process.…”

The problem of maxillary sinusitis after sinus lift and dental implantation: A review of literature

“…Даже высокая часто та перфораций слизистой оболочки верхнечелюст ной пазухи при проведении синуслифтинга (от 20 до 85%), по мнению большинства зарубежных авторов, редко является причиной развития ВЧС [15][16][17][18][19][20]. Однако, по другим данным, частота развития ВЧС после проведения синуслифтинга составляет 26% [6, [21][22][23][24][25][26], что в большинстве случаев заканчивает ся потерей аугментированного костного или косте замещающего материала и импланта [27]. После операционный отек слизистой оболочки верхнече люстной пазухи, скопление в полости сгустков кро ви могут приводить к блокаде остиомеатального комплекса [28,29].…”