Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-28T00:20:01.549Z Has data issue: false hasContentIssue false

Bone changes after maxillary sinus surgery: an experimental scanning electron microscopy study

Published online by Cambridge University Press:  12 July 2007

P M Moreno*
Affiliation:
Department of Otolaryngology, Medical School, Santa Maria Hospital, Lleida
D H Meseguer
Affiliation:
Department of Otolaryngology, Vega Baja Hospital, Alicante, Spain
*
Address for correspondence: Dr Pablo Melgarejo, Hospital Santa Maria, Alcalde Rovira Roure 44, 25006 Lleida, Spain. Fax: +34 973727223 E-mail: [email protected]

Abstract

Aims:

The purpose of this study was to explore the pathogenic role of bone in sinus surgery, and to determine whether mucosal disease after sinus surgery may be induced by underlying disease within the bone.

Material and methods:

Twenty-five rabbits were divided into five groups. In group one, wide surgical removal of the maxillary sinus mucosa and creation of a nasoantral window were undertaken. In group two, only nasoantral window creation was undertaken. In group three, the mucosa of the anterior maxillary sinus was removed. In group four, a strip of mucosa around the ostium was removed. Group five was used as a control.

Results:

After three months, in the groups which had undergone wide surgical removal, the medial sinus walls were observed to be retracted and the inner curtain of the bone disturbed, with alteration of the haversian canal system and osteoclastic bone resorption.

Conclusions:

After radical sinus surgery, electron microscopic changes were observed in the bony walls, similar to those changes seen in osteomyelitis.

Type
Main Article
Copyright
Copyright © JLO (1984) Limited 2007

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 at the 21st Congress of the European Rhinologic Society and the 25th International Symposium on Infection and Allergy of the Nose, Tampere, Finland, 11–15 June 2006.

References

1 Perloff, JR, Gannon, FH, Bolger, WE, Montone, KT, Orlandi, R, Kennedy, DW. Bone involvement in sinusitis: an apparent pathway for the spread of disease. Laryngoscope 2000;110:20952099CrossRefGoogle ScholarPubMed
2 Tos, M, Mogensen, C. Mucus production in chronic maxillary sinusitis. A quantitative histopathological study. Acta Otolaryngol (Stockh) 1984;97:151–9CrossRefGoogle ScholarPubMed
3 Khalid, AN, Hunt, J, Perloff, JR, Kennedy, DW. The role of bone in chronic rhinosinusitis. Laryngoscope 2002;112:1951–7CrossRefGoogle ScholarPubMed
4 Stammberger, H. Endoscopic endonasal surgery – concepts in treatment of recurring rhinosinusitis. Part I. Anatomic and pathophysiologic considerations. Otolaryngol Head Neck Surg 1986;94:143–7CrossRefGoogle ScholarPubMed
5 Kennedy, DW, Shaalan, H. Re-evaluation of maxillary sinus surgery: Experimental study in rabbits. Ann Otol Rhinol Laryngol 1989;98:901–6CrossRefGoogle Scholar
6 Lund, VJ. Inferior meatal antrostomy. Fundamental considerations of design and function. J Laryngol Otol Suppl 1988;15(suppl):118CrossRefGoogle ScholarPubMed
7 Melgarejo-Moreno, P, Ribera-Cortada, I, Hellin-Meseguer, D. Submucosal glands after maxillary sinus surgery. An experimental study in rabbits. J Laryngol Otol 1996;110:644–8CrossRefGoogle ScholarPubMed
8 Kelemen, G. The nasal and paranasal cavities of the rabbit in experimental work. Arch Otolaryngol 1955;61:497512CrossRefGoogle ScholarPubMed
9 Jeon, SY, Rhee, CK, Jeong, PS, Min, YG. Ultrastructural changes in platelet activating factor-induced epithelial damage in rabbit maxillary sinus mucosa. Ann Otol Rhinol Laryngol 2004;113:477–82Google Scholar
10 Maccabee, MS, Trune, DR, Hwang, PH. Effects of topically applied biomaterials on paranasal sinus mucosal healing. Am J Rhinol 2003;17:203–7CrossRefGoogle ScholarPubMed
11 Yang, PC, Liu, T, Wang, CS, Zhang, NZ, Tao, ZD. Active ion secretion and permeability of rabbit maxillary sinus epithelium, impact of staphylococcal enterotoxin B. Otolaryngol Head Neck Surg 2000;123:120–3CrossRefGoogle ScholarPubMed
12 Gilbert, ME, Kirker, KR, Gray, SD, Ward, PD, Szakacs, JG, Prestwich, GD et al. Condroitin sulfate hydrogel and wound healing in rabbit maxillary sinus mucosa. Laryngoscope 2004;114:1406–9CrossRefGoogle Scholar
13 Forsgren, K, Otori, N, Stierna, P, Kumlien, J. Microvasculature, blood flow, and vasoreactivity in rabbit sinus mucosa after surgery. Laryngoscope 1999;109:562–8CrossRefGoogle ScholarPubMed
14 Forsgren, K, Jung, YG, Stierna, P, Rivero, C. Regeneration of nerve fibres in the maxillary sinus mucosa after experimental surgery. Acta Otolaryngol (Stockh) 1999;119:486–91Google ScholarPubMed
15 Maccabee, MS, Trune, DR, Hwang, PH. Paranasal sinus mucosal regeneration: the effect of topical retinoic acid. Am J Rhinol 2003;17:133–7CrossRefGoogle ScholarPubMed
16 Forsgren, K, Stierna, P, Kumlien, J, Carlsöö, B. Regeneration of maxillary sinus mucosa following surgical removal. Experimental study in rabbits. Ann Otol Rhinol Laryngol 1993;102:459–66CrossRefGoogle ScholarPubMed
17 Kennedy, DW, Senior, BA, Gannon, FH, Montone, KT, Hwang, P, Lanza, DC. Histology and histomorphometry of ethmoid bone in chronic rhinosinusitis. Laryngoscope 1998;108:502–7CrossRefGoogle ScholarPubMed
18 Forsgren, K, Westrin, KM, Fukami, M, Stierna, P. Effects of surgery on mucosal pathologic changes following experimental sinusitis in rabbit. Ann Otol Rhinol Laryngol 1998;107:155–63CrossRefGoogle ScholarPubMed
19 Hwang, P, Montone, KT, Gannon, FH, Senior, BA, Lanza, DC, Kennedy, DW. Applications of in situ hybridization techniques in the diagnosis of chronic sinusitis. Am J Rhinol 1999;13:335–8CrossRefGoogle ScholarPubMed
20 Kern, RC. Chronic sinusitis and anosmia: pathologic changes in the olfactory mucosa. Laryngoscope 2000;110:1071–7CrossRefGoogle ScholarPubMed
21 Melgarejo-Moreno, P, Ribera-Cortada, I, Sarroca-Capell, E. Radical or partial maxillary sinus surgery: a dilemma today? An experimental study. Rhinology 1996;34:110–13Google ScholarPubMed
22 Perko, D, Karin, RR. Nasoantral windows: an experimental study in rabbits. Laryngoscope 1992;102:320–6CrossRefGoogle ScholarPubMed
23 Friedman, M, Tourini, DM. The effect of a temporary nasoantral window on mucociliary clearance. An experimental study. Otolaryngol Clin North Am 1989;22:819–30CrossRefGoogle ScholarPubMed