Histopathologic evaluation of the ethmoid bone in chronic sinusitis

Chronic rhinosinusitis (CRS) is defined as a condition lasting for a period greater than 12 weeks, and manifested by an inflammatory response involvin g the mucous membranes of the nasal cavity and paranasal sinuses, fluids wi thin these cavities, and/or the underlying bone. The mucosal changes that o ccur in CRS have been well described, and include edema, decreased number o f ciliated cells, and goblet cell hyperplasia. However, the changes that ma y occur in the underlying ethmoid bone have only recently been investigated . We evaluated decalcified ethmoid bone specimens from 20 patients undergoi ng endoscopic sinus surgery for CRS. Our analysis revealed histopathologic changes consistent with varying grades of bone remodeling. Polarized light microscopy demonstrated changes in the extracellular matrix, such as bone r esorption and neo-osteogenesis. Preoperative clinical data and CT staging w ere recorded on all patients and correlated with the histopathologic findin gs. These findings suggest that CRS may be associated with osteitis of the underlying ethmoid bone.