Potential conflict of interest: None provided.
Osteitis in chronic rhinosinusitis: a review of the literature
Article first published online: 19 DEC 2012
© 2013 ARS-AAOA, LLC
International Forum of Allergy & Rhinology
Volume 3, Issue 5, pages 355–363, May 2013
How to Cite
How to Cite this Article: Osteitis in chronic rhinosinusitis: a review of the literature. Int Forum Allergy Rhinol, 2013; 3:355–363., , ,
- Issue published online: 17 MAY 2013
- Article first published online: 19 DEC 2012
- Manuscript Accepted: 8 AUG 2012
- Manuscript Revised: 9 JUL 2012
- Manuscript Received: 9 MAY 2012
- bone involvement;
- bone remodeling;
- chronic rhinosinusitis;
- computed tomography (CT);
- single photon emission computed tomography (SPECT);
- nuclear scintigraphy;
The role of osteitis, or inflammation involving bone, is 1 potential reason for disease recalcitrance in chronic rhinosinusitis (CRS) and is not extensively studied. This review article will discuss osteitis in CRS, including pathophysiology, diagnostic methods, clinical significance, and treatment modalities.
A systematic review of the literature was performed using PubMed search terms osteitis, osteomyelitis, bone involvement, hyperostosis, neo-osteogenesis, osteoneogenesis, remodeling, single positron emission computed tomography (SPECT), and nuclear scintigraphy, with each term cross-referenced with chronic rhinosinusitis. This search was then narrowed to English language articles, which were reviewed for relevance. Cited references of relevant articles were also examined.
The PubMed search identified 231 articles, which after reviewing for inclusion criteria resulted in 26 articles that were included in the current review. Pathophysiology, including current understanding of molecular mechanisms contributing to osteitis, is discussed. Histology, computed tomography (CT), and SPECT have been used to establish a diagnosis. Radiographic staging systems exist but are not standardized. Osteitis has been treated both with intravenous antibiotics and surgery. Five articles involved assessment of outcomes in patients with osteitis.
Osteitis involves inflammatory changes in the underlying bone that may lead to recalcitrant CRS. Osteitis is associated with worsened measures of disease severity such as CT, endoscopy, and olfactory scores, and affects the degree of improvement in quality-of-life measures after both medical and surgical treatment. Future studies directed at characterizing the underlying molecular mechanisms including earlier and precise identification may improve our ability to treat this significant aspect of CRS.