Kornkiat Snidvongs1,2, Raymond Sacks3,4, Richard J Harvey3,5. 1. Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. drkornkiat@yahoo.com. 2. Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. drkornkiat@yahoo.com. 3. Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia. 4. University of Sydney, Sydney, Australia. 5. Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
Abstract
PURPOSE OF REVIEW: Osteitis is recognized as a common factor in recalcitrant chronic rhinosinusitis (CRS). There is evidence for the association of osteitis with revision surgeries and CRS severity, in terms of higher Lund-Mackay scores. This is a narrative review on the osteitis in CRS patients. RECENT FINDINGS: Evidence to date is inconclusive with regard to the etiology and pathogenesis of this bony thickening. Histopathology of osteitis in primary CRS is likely a process of neo-osteogenesis and bone remodeling. For better understanding, various associating factors have been studied including an inflammatory pattern of rhinosinusitis. Recent studies have associated osteitis with nasal polyps and tissue eosinophilia with the increase in periostin expression and P-glycoprotein mucosal expression. There is no association of osteitis to symptoms or quality of life. Osteitis is an outcome of neo-osteogenesis rather than inflammatory processes in CRS patients without a prior history of surgery. While CT has become a staple in osteitis assessment, the standards for grading osteitic severity remain in an experimental stage. There is no association between the presence or severity of osteitis at the time of surgery and clinical outcomes at 1 year after surgery. This review provides a comprehensive overview of the pathogenesis, epidemiology, and correlation with clinical and biological factors of osteitis in CRS patients.
PURPOSE OF REVIEW: Osteitis is recognized as a common factor in recalcitrant chronic rhinosinusitis (CRS). There is evidence for the association of osteitis with revision surgeries and CRS severity, in terms of higher Lund-Mackay scores. This is a narrative review on the osteitis in CRSpatients. RECENT FINDINGS: Evidence to date is inconclusive with regard to the etiology and pathogenesis of this bony thickening. Histopathology of osteitis in primary CRS is likely a process of neo-osteogenesis and bone remodeling. For better understanding, various associating factors have been studied including an inflammatory pattern of rhinosinusitis. Recent studies have associated osteitis with nasal polyps and tissue eosinophilia with the increase in periostin expression and P-glycoprotein mucosal expression. There is no association of osteitis to symptoms or quality of life. Osteitis is an outcome of neo-osteogenesis rather than inflammatory processes in CRSpatients without a prior history of surgery. While CT has become a staple in osteitis assessment, the standards for grading osteitic severity remain in an experimental stage. There is no association between the presence or severity of osteitis at the time of surgery and clinical outcomes at 1 year after surgery. This review provides a comprehensive overview of the pathogenesis, epidemiology, and correlation with clinical and biological factors of osteitis in CRSpatients.
Authors: Peter Karempelis; Emily Karp; Nathan Rubin; Ryan Hunter; Jordan Dunitz; Holly Boyer Journal: Int Forum Allergy Rhinol Date: 2019-12-19 Impact factor: 3.858
Authors: Madison J Malfitano; Griffin D Santarelli; Mark Gelpi; William C Brown; Wesley H Stepp; Stephen Hernandez; Adam J Kimple; Brian D Thorp; Adam M Zanation; Charles S Ebert Journal: Am J Rhinol Allergy Date: 2020-07-13 Impact factor: 2.467