Skip to main content
SpringerLink
Log in

Osteitis and chronic rhinosinusitis: a review of the current literature

  • Review Article
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Chronic rhinosinusitis is a common debilitating condition characterized by inflammation of the nose and paranasal sinuses. Osteitis is an associated finding but it is not clear whether it is cause or effect. This review will report on studies that have examined the role of osteitis in CRS, with the ultimate aim of clarifying the definition, pathogenesis and clinical implications of this relatively new clinical entity. Literature searches of Medline, EMBASE and CENTRAL using the search terms osteitis, rhinosinusitis, sinusitis, rhinitis, chronic disease, and recurrence were performed. 21 articles were identified and reviewed. The papers highlighted key pathological features including periosteal thickening, new woven bone formation, bone resorption, fibrosis and inflammatory cell infiltration. Radiological grading systems and basic science research into the role of matrix metalloproteinases and P-glycoprotein were also identified and reviewed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Fokkens WJLVJ, Mullol J et al (2012) European position paper on rhinosinusitis and nasal polyps 2012. Rhinology 50:1–298

    PubMed  Google Scholar 

  2. Hastan DFWJ, Bachert C et al (2011) Chronic rhinosinusitis in Europe—an underestimated disease. A GA(2)LEN study. Allergy 66:1216–1223

    Article  CAS  PubMed  Google Scholar 

  3. Gliklich REMR (1995) The health impact of chronic sinusitis in patients seeking otolaryngologic care. Otolaryngol Head Neck Surg 113:104–109

    Article  CAS  PubMed  Google Scholar 

  4. Bhattacharyya N (2011) Incremental health care utilization and expenditures for chronic rhinosinusitis in the United States. Ann Otol Rhin Laryng 120:423–427

    Article  Google Scholar 

  5. Goetzel RZHK, Ozminkowski RJ et al (2003) The health and productivity cost burden of the “top 10” physical and mental health conditions affecting six large US employers in 2009. J Occup Environ Med 45:5–14

    Article  PubMed  Google Scholar 

  6. Westrin KM, Norlander T, Stierna P, Carlsoo B, Nord CE (1992) Experimental maxillary sinusitis induced by Bacteroides fragilis. A bacteriological and histological study in rabbits. Acta Otolaryngol 112:107–114

    Article  CAS  PubMed  Google Scholar 

  7. Norlander T, Westrin KM, Stierna P (1994) The inflammatory response of the sinus and nasal mucosa during sinusitis: implications for research and therapy. Acta Otolaryngol Suppl 515:38–44

    Article  CAS  PubMed  Google Scholar 

  8. Tovi F, Benharroch D, Gatot A, Hertzanu Y (1992) Osteoblastic osteitis of the maxillary sinus. Laryngoscope 102:426–430

    Article  CAS  PubMed  Google Scholar 

  9. Giacchi RJ, Lebowitz RA, Yee HT, Light JP, Jacobs JB (2001) Histopathologic evaluation of the ethmoid bone in chronic sinusitis. Am J Rhinol 15:193–197

    Article  CAS  PubMed  Google Scholar 

  10. Snidvongs K, Earls P, Dalgorf D, Sacks R, Pratt E, Harvey RJ (2014) Osteitis is a misnomer: a histopathology study in primary chronic rhinosinusitis. Int Forum Allergy Rhinol 4:390–396

    Article  PubMed  Google Scholar 

  11. Lee JT, Kennedy DW, Palmer JN, Feldman M, Chiu AG (2006) The incidence of concurrent osteitis in patients with chronic rhinosinusitis: a clinicopathological study. Am J Rhinol 20:278–282

    Article  PubMed  Google Scholar 

  12. Cho SH, Min HJ, Han HX, Paik SS, Kim KR (2006) CT analysis and histopathology of bone remodeling in patients with chronic rhinosinusitis. Otolaryngol Head Neck Surg 135:404–408

    Article  PubMed  Google Scholar 

  13. Kennedy DWSBA, Gannon FH et al (1998) Histology and histomorphometry of ethmoid bone in chronic rhinosinusitis. Laryngoscope 108:502–507

    Article  CAS  PubMed  Google Scholar 

  14. Biedlingmaier JF, Whelan P, Zoarski G, Rothman M (1996) Histopathology and CT analysis of partially resected middle turbinates. Laryngoscope 106:102–104

    Article  CAS  PubMed  Google Scholar 

  15. Snidvongs K, McLachlan R, Sacks R, Earls P, Harvey RJ (2013) Correlation of the Kennedy Osteitis Score to clinico-histologic features of chronic rhinosinusitis. Int Forum Allergy Rhinol 3:369–375

    Article  PubMed  Google Scholar 

  16. Georgalas C, Videler W, Freling N, Fokkens W (2010) Global Osteitis Scoring Scale and chronic rhinosinusitis: a marker of revision surgery. Clin Otolaryngol 35:455–461

    Article  CAS  PubMed  Google Scholar 

  17. Catalano PJ, Dolan R, Romanow J, Payne SC, Silverman M (2007) Correlation of bone SPECT scintigraphy with histopathology of the ethmoid bulla: preliminary investigation. Ann Otol Rhinol Laryngol 116:647–652

    Article  PubMed  Google Scholar 

  18. Detwiller KY, Smith TL, Mace JC, Trune DR, Sautter NB (2013) Steroid-independent upregulation of matrix metalloproteinase 9 in chronic rhinosinusitis patients with radiographic evidence of osteitis. Int Forum Allergy Rhinol 3:364–368

    Article  PubMed  PubMed Central  Google Scholar 

  19. Gunel C, Feldman RE, Bleier BS (2014) Osteitis is associated with P-glycoprotein overexpression in patients with chronic sinusitis without nasal polyps. Am J Rhinol Allergy 28:99–102

    Article  PubMed  Google Scholar 

  20. Feldman RE, Lam AC, Sadow PM, Bleier BS (2013) P-glycoprotein is a marker of tissue eosinophilia and radiographic inflammation in chronic rhinosinusitis without nasal polyps. Int Forum Allergy Rhinol 3:684–687

    Article  PubMed  Google Scholar 

  21. Sacks PL, Snidvongs K, Rom D, Earls P, Sacks R, Harvey RJ (2013) The impact of neo-osteogenesis on disease control in chronic rhinosinusitis after primary surgery. Int Forum Allergy Rhinol 3:823–827

    Article  PubMed  Google Scholar 

  22. Snidvongs K, McLachlan R, Chin D et al (2012) Osteitic bone: a surrogate marker of eosinophilia in chronic rhinosinusitis. Rhinology 50:299–305

    CAS  PubMed  Google Scholar 

  23. Bhandarkar ND, Mace JC, Smith TL (2011) The impact of osteitis on disease severity measures and quality of life outcomes in chronic rhinosinusitis. Int Forum Allergy Rhinol 1:372–378

    Article  PubMed  PubMed Central  Google Scholar 

  24. Saylam G, Gorgulu O, Korkmaz H, Dursun E, Ortapamuk H, Eryilmaz A (2009) Do single-photon emission computerized tomography findings predict severity of chronic rhinosinusitis: a pilot study. Am J Rhinol Allergy 23:172–176

    Article  PubMed  Google Scholar 

  25. Zuo K, Guo J, Chen F et al (2014) Clinical characteristics and surrogate markers of eosinophilic chronic rhinosinusitis in Southern China. Eur Arch Otorhinolaryngol 271:2461–2468

    Article  PubMed  Google Scholar 

  26. Ye T, Hwang PH, Huang Z et al (2014) Frontal ostium neo-osteogenesis and patency after Draf III procedure: a computer-assisted study. Int Forum Allergy Rhinol 4:739–744

    Article  PubMed  Google Scholar 

  27. Telmesani LM, Al-Shawarby M (2010) Osteitis in chronic rhinosinusitis with nasal polyps: a comparative study between primary and recurrent cases. Eur Arch Otorhinolaryngol 267:721–724

    Article  PubMed  Google Scholar 

  28. Cho SHSKS, Lee YS, Jeong JH, Lee SH, Tae K, Kim KR (2008) Impact of chronic rhinosinusitis and endoscopic sinus surgery on bone remodeling of the paranasal sinuses. Am J Rhinol 22:537–541

    Article  PubMed  Google Scholar 

  29. Kim HY, Dhong HJ, Lee HJ et al (2006) Hyperostosis may affect prognosis after primary endoscopic sinus surgery for chronic rhinosinusitis. Otolaryngol Head Neck Surg 135:94–99

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to acknowledge Mr. Jason Yuen and Dr. Theodore Pezas for their contributions to the literature search.

Author information

Authors and Affiliations

  1. Department of ENT, John Radcliffe Hospital, Oxford, UK

    N. Leung, T. A. R. Mawby, H. Turner & A. Qureishi

Authors
  1. N. Leung
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. A. R. Mawby
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Turner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Qureishi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N. Leung.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Leung, N., Mawby, T.A.R., Turner, H. et al. Osteitis and chronic rhinosinusitis: a review of the current literature. Eur Arch Otorhinolaryngol 273, 2917–2923 (2016). https://doi.org/10.1007/s00405-015-3817-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-015-3817-0

Keywords

Search

Navigation