Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-25T11:34:19.528Z Has data issue: false hasContentIssue false
  • English
  • Français

Sinonasal bony changes in nasal polyposis: prevalence and relationship to disease severity

Published online by Cambridge University Press:  18 July 2013

J Siddiqui ,
R Millard ,
A Z Eweiss ,
T Beale  and
V J Lund
J Siddiqui*
Affiliation:
Department of Rhinology, Royal National Throat, Nose and Ear Hospital, London, UK
R Millard
Affiliation:
Department of Rhinology, Royal National Throat, Nose and Ear Hospital, London, UK
A Z Eweiss
Affiliation:
Department of Rhinology, Royal National Throat, Nose and Ear Hospital, London, UK Department of Otolaryngology, Alexandria Faculty of Medicine, Egypt
T Beale
Affiliation:
Department of Rhinology, Royal National Throat, Nose and Ear Hospital, London, UK
V J Lund
Affiliation:
Department of Rhinology, Royal National Throat, Nose and Ear Hospital, London, UK
*
Address for correspondence: Miss J Siddiqui, Department of Rhinology, Royal National Throat, Nose and Ear Hospital, 330–332 Gray's Inn Rd, London WC1X 8DA, UK Fax: +44 (0)207 833 9480 E-mail: juveria@doctors.org.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Nasal polyposis is characterised by opacification of the nasal cavities, paranasal sinuses and ostiomeatal complexes on computed tomography scanning. Sinonasal bony changes have been reported as disease sequelae.

Objectives:

To assess the prevalence of sinonasal bone expansion, erosion and thickening in patients with nasal polyposis, and to correlate disease severity with the prevalence of bony changes.

Methods:

A retrospective radiological study was conducted comprising pre-operative computed tomography scans of 104 patients with nasal polyposis and scans of 44 age- and gender-matched individuals (control group) without sinonasal disease. Lund–Mackay scores and bony changes were quantified.

Results:

Ninety-three per cent of the study group scans showed sinonasal bony change, with no changes in the control group. Radiological severity of nasal polyposis correlated positively with the prevalence of bony changes (rs = 0.31; p < 0.01).

Conclusion:

Sinonasal bony changes were common in the study group. This highlights the importance of pre- and intra-operative imaging, which can help to prevent intra-operative complications. As bony changes may mimic invasive disease, the importance of histological assessment of polyps is emphasised.

Keywords

Nasal PolypsRhinitisSinusitisParanasal SinusesParanasal Sinus DiseasesBoneCT ScanX-Ray
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 8 , August 2013 , pp. 755 - 759
Copyright
Copyright © JLO (1984) Limited 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented as a poster at the 14th British Academic Conference in Otolaryngology, 4–6 July 2012, Glasgow, Scotland, UK.

References

1Lund, VJ. Diagnosis and treatment of nasal polyps. BMJ 1995;311:1411–14CrossRefGoogle ScholarPubMed
2Scadding, GK, Durham, SR, Mirakian, R, Jones, NS, Drake-Lee, AB, Ryan, D et al. BSACI guidelines for the management of rhinosinusitis and nasal polyposis. Clin Exp Allergy 2008;38:260–75CrossRefGoogle ScholarPubMed
3Fokkens, W, Lund, V, Mullol, J. European position paper on rhinosinusitis and nasal polyps 2007. Rhinol Suppl 2007;20:1–136Google ScholarPubMed
4Kantarci, M, Karasen, RM, Alper, F, Onbas, O, Okur, A, Karaman, A et al. Remarkable anatomical variations in paranasal sinus region and their clinical importance. Eur J Radiol 2004;50:296–302CrossRefGoogle ScholarPubMed
5Lund, VJ, Lloyd, GA. Radiological changes associated with benign nasal polyps. J Laryngol Otol 1983;97:503–10CrossRefGoogle ScholarPubMed
6Liu, JK, Schaefer, SD, Moscatello, AL, Couldwell, WT. Neurosurgical implications of allergic fungal sinusitis. J Neurosurg 2004;100:883–90CrossRefGoogle ScholarPubMed
7Banna, M, Ewaschuk, EJ, Cole, FM. Erosion of the pituitary fossa by benign nasal polyps. J Can Assoc Radiol 1977;28:300–2Google ScholarPubMed
8Som, PM, Lawson, W, Lidov, MW. Simulated aggressive skull base erosion in response to benign sinonasal disease. Radiology 1991;180:755–9CrossRefGoogle ScholarPubMed
9Bent, JP 3rd, Kuhn, FA. Diagnosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg 1994;111:580–8CrossRefGoogle ScholarPubMed
10de Vries, N. New bone formation in nasal polyps. Rhinology 1988;26:217–19Google ScholarPubMed
11Rejowski, JE, Caldarelli, DD, Campanella, RS, Penn, RD. Nasal polyps causing bone destruction and blindness. Otolaryngol Head Neck Surg 1982;90:505–6CrossRefGoogle ScholarPubMed
12Connor, SE, Hussain, S, Woo, EK-F. Sinonasal imaging. Imaging 2007;19:39–54CrossRefGoogle Scholar
13Videler, WJ, Georgalas, C, Menger, DJ, Freling, NJ, van Drunen, CN, Fokkens, WJ. Osteitic bone in recalcitrant chronic rhinosinusitis. Rhinology 2011;49:139–47CrossRefGoogle ScholarPubMed
14Lund, VJ, Mackay, IS. Staging in rhinosinusitis. Rhinology 1993;31:183–4Google Scholar
15Lee, JT, Kennedy, DW, Palmer, JN, Feldman, M, Chiu, AG. The incidence of concurrent osteitis in patients with chronic rhinosinusitis: a clinicopathological study. Am J Rhinol 2006;20:278–82CrossRefGoogle ScholarPubMed
16Majithia, A, Tatla, T, Sandhu, G, Saleh, HA, Clarke, PM. Intracranial polyps in patients with Samter's triad. Am J Rhinol 2007;21:59–63CrossRefGoogle ScholarPubMed
17Kim, HY, Dhong, HJ, Lee, HJ, Chung, YJ, Yim, YJ, Oh, JW et al. Hyperostosis may affect prognosis after primary endoscopic sinus surgery for chronic rhinosinusitis. Otolaryngol Head Neck Surg 2006;135:94–9Google ScholarPubMed
18Kaluskar, SK, Patil, NP, Sharkey, AN. The role of CT in functional endoscopic sinus surgery. Rhinology 1993;31:49–52Google ScholarPubMed
19Hopkins, C, Browne, JP, Slack, R, Lund, VJ, Topham, J, Reeves, BC et al. Complications of surgery for nasal polyposis and chronic rhinosinusitis: the results of a national audit in England and Wales. Laryngoscope 2006;116:1494–9CrossRefGoogle Scholar
20Georgalas, C, Videler, W, Freling, N, Fokkens, W. Global Osteitis Scoring Scale and chronic rhinosinusitis: a marker of revision surgery. Clin Otolaryngol 2010;35:455–61CrossRefGoogle ScholarPubMed
21Diamantopoulos, II, Jones, NS, Lowe, J. All nasal polyps need histological examination: an audit-based appraisal of clinical practice. J Laryngol Otol 2000;114:755–9CrossRefGoogle ScholarPubMed