الفهرس 
Anatomy of Paranasal SinusOnly 14 pages are availabe for public view
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Abstract
Background:
In the field of rhinology, the majority of studies focus on mucosal immunology of the nose without giving attention to the underlying bones. Recent evidence indicates that the inflammation of chronic rhinosinusitis (CRS) is beyond the mucous membrane and involves the underlying bone of the paranasal sinuses as well. In the current study we tried to assess the prescence of osteitis in ethmoid bone and tissue eosinophilia in nasal mucosa of patients with chronic rhinosinusitis.
Patient and Method:
A total of 85 patients (37 females and 48 males) who underwent surgery in our university hospital contributed to this study by providing bone samples from the ethmoid bone. They were divided into four groups: group I are Allergic Fungal Sinusitis (AFS) patients; group II are chronic Rhinosinusitis patients without nasal polyp (CRSsNP); group III are chronic Rhinosinusitis patients with nasal polyp (CRSwNP) and group IV are patients who underwent septoplasty as control group. Histological evaluation for osteitis (periosteal thickening and remodeling, osteoblastic and osteoclastic activity, and osteomyelitis and bone destruction) that was graded from 0 to IV, where grade 0 is normal histology and grade IV is frank osteomyelitis and bone destruction.
Results:
Descriptive histology of the ethmoid bone analysis demonstrated osteitis of different grades in patients suffering from CRS: AFS patients; grade I (13.3%), grade II (46.7%), grade III (33.3%) and grade IV (6.7%). CRSsNP patients; grade 0 (10%), grade I (30%), grade II (40%), grade III (16.7%) and grade IV (3.3%). CRSwNP patients; grade 0 (10%), grade I (50%), grade II (20%), grade III (20%) and Control patients(DNS); grade 0 (70%), grade I (30%).
Conclusion:
Herein, we show evidence of osteitis in CRS and confirm the presence of a higher grade osteitis in the AFS patients. This sinus bone remodeling may contribute to the chronicity of the disease and carries special consideration in the treatment of CRS.