THE INFLAMMATORY RESPONSE OF THE SINUS AND NASAL-MUCOSA DURING SINUSITIS - IMPLICATIONS FOR RESEARCH AND THERAPY

Since it is difficult to evaluate the state of an infected sinus mucos a by histopathology, much of the present knowledge of the morphology i n sinusitis is based on animal experiments. When experimental sinusiti s is induced in the rabbit, the inflammatory response in the nose appe ars to be more pronounced than that in the maxillary sinus. In the ani mal model, histological findings include epithelial desquamation, edem a, goblet cell hyperplasia and, in severe cases, fibrosis, bone reacti on and formation of polyps in the nose and in the antrum. These local pathological findings may persist in the nasal middle meatus and the p aranasal sinuses for a considerable time and predispose the mucosa to recurrences of infection. By investigation with recently introduced ad vanced techniques such as magnetic resonance imaging (MRI), a protract ed pathological state in the sinus mucosa can be recorded also in huma ns for months after an episode of acute sinusitis. Future human and ex perimental studies of the local inflammatory response and of the cellu lar pathology over time will yield further guidelines for improved the rapy and prevention of acute sinusitis.