Tissue remodeling plays an important role among the many factors that determine the severe long course of chronic rhinosinusitis (CRS).
OBJECTIVE
To study the processes of bone remodeling according to computed tomography in CRS patients with polyps and severe long course of the disease.
PATIENTS AND METHODS
A retrospective analysis of the results of spiral computed tomography (SCT) of patients with severe course of CRS with polyps was performed. The study group included 20 patients. The results of the SCT examination during initial presentation (at that time, the average duration of the disease was 10 years) were selected for analysis, as well as in dynamics: on average 34 and 84 months from the initial study. The control group consisted of 20 patients without inflammatory changes of the paranasal sinuses, who underwent SCT twice for different indications with an average interval of 32 months. Linear dimensions and bone density in Hounsfield units were determined in the analysis of SCT results.
RESULTS
Comparison of the initial indicators of the study and control groups has revealed a significant increase in the density of the intersinusal septums of the frontal and sphenoidal sinuses without a significant change in their thickness, as well as a significant increase in the density and thickness of the posterior walls of the maxillary sinuses. There were no differences in the transverse dimension of the ethmoidal sinus in the study and control groups. A progressive increase of the thickness of the posterior walls of the maxillary sinuses has been noted in repeated investigations.
CONCLUSIONS
A progressive increase in the thickness of the sinuses’ walls and their density indicates the development of osteitis, which is one of the factors determining the long severe course of the disease.