Subsequent Sinusitis Research Articles

Identification of Risk Factors for Coexisting Sinusitis and Inflammatory Bowel Disease.

This study aimed to analyze the association of coexisting sinusitis and IBD, establish significant factors involved in their development, and enable further biological correlation between these two diseases. The IBD and Sinusitis Study at UChicago Medicine (TISSUe) is a retrospective, single-center study. We reviewed patients to confirm IBD and chronic sinusitis diagnoses. Case-control propensity score matching was performed using matched controls with IBD only or sinusitis only. Statistical methods included Chi-squared test and Wilcoxon rank sum test. Logistic regression analysis was performed, and factors were considered significant if p<0.05. Stratifying 214 patients with coexisting IBD and sinusitis, 176 patients had IBD first and 38 patients had sinusitis first. Multivariable analysis of factors associated with subsequent disease with matched controls determined that duration of disease, UC, steroid exposure ever, and younger age of IBD diagnosis were associated with subsequent sinusitis in patients with IBD; steroid exposure ever and duration of sinusitis were significantly associated with subsequent IBD in patients with sinusitis. This study suggests that IBD maintenance therapies are not associated with increased risk of sinusitis, as proposed by adverse events in clinical trial data; rather, UC diagnosis and duration of disease may be more influential in sinusitis development. While further studies are necessary, this study also demonstrates that sinusitis precedes IBD in some patients, probing its biological association with IBD and possible classification as an extraintestinal manifestation.

Case study: Tooth root infection and subsequent sinusitis in an aged mare

Case study: Tooth root infection and subsequent sinusitis in an aged mare

Probiotic E.faecalis — adjuvant therapy in children with recurrent rhinosinusitis

Abstract Sinusitis is a frequent complication of respiratory tract infections. Probiotics are perceived to be useful in infections, allergies, and inflammations. Our prospective trial stratified 204 children with recurrent rhinosinusitis by age (2–11 years, 54m:64f; 12–18 years, 39m:47f) and assigned them to standard treatment (antibiotics, anticongestants) or additional 60 days Symbioflor-1 (SF1; Enterococcus faecalis 1.5–4.5x107 CFU). The number of sinusitis episodes was lower in SF1-treated patients (2.52±0.91) than among controls (3.27±1.36; p=0.01). Mean duration of the first sinusitis episode was 11.9±8.6 days with SF1, whereas it was 16.1±12.9 days in the younger controls (p=0.023) and 9.86±5.05 days in the elder controls (n.s.). Duration of subsequent sinusitis episodes was also shorter in SF1 patients (15.2±13.6 days) compared with controls (22.7±14.8 days; p=0.030). No adverse events were observed. Probiotic Enterococcus faecalis adjuvant to conventional therapy can reduce the number and duration of rhinosinusitis episodes in children and adolescents.

Characteristics and risk factors of mucosal cysts in the paranasal sinuses

Though mucosal cysts in the paranasal sinuses (PSMCs) are common findings on radiographic images, the nature of PSMCs and risk factors for the development of PSMCs have not yet been determined. The aim of this study was to evaluate the characteristics of PSMCs using brain magnetic resonance (MR) imaging. A total of 6831 subjects who underwent health checkup including brain MR imaging were included in this study. The characteristics of PSMCs, including their location, number and size, as well as the presence of obstruction of the sinus ostium and sinusitis, were analysed using brain MR images. Structured questionnaires and medical records were reviewed to evaluate the smoking status and comorbid medical conditions. The overall prevalence of PSMCs was 7.4% and was significantly higher in females than in males. PSMCs were most commonly found in the maxillary sinus, most of which were located unilaterally as a solitary cyst. Large cysts were associated with obstruction of the sinus ostium and subsequent sinusitis. Smoking was a single important risk factor for developing PSMCs. No significant associations were found between symptoms (nasal/respiratory) and the presence of PSMCs. The prevalence of PSMCs was 7.4% and decreased with age. Large cysts may lead to obstruction of the sinus and subsequent sinusitis. Smoking was an important risk factor for PSMCs, and the total amount of smoking correlated with cyst size. Most subjects were asymptomatic, and specific treatment was not performed.

Mucosal Cysts in the Paranasal Sinuses: Long-term Follow-up and Clinical Implications

Although mucosal cysts in the paranasal sinuses (PSMCs) are commonly detected, the long-term follow-up studies of PSMCs are sparse. This study evaluated the natural course of PSMCs and identified risk factors for the disease progression. A total of 133 subjects with PSMCs who underwent health checkup including brain magnetic resonance imaging more than two times with an interval of ≥24 months between January 2000 and December 2009 were included. The characteristics of PSMCs were analyzed on the initial and follow-up images. Nasal symptoms, smoking status, and comorbid medical conditions were evaluated using structured questionnaires and medical records. The mean follow-up duration was 40.38 months (range, 24.0-109.8 months). The mean size of PSMCs decreased from 15.07 to 12.73 mm. Only 8.3% of subjects showed an increase in size, whereas the size of cysts was decreased or unchanged in the remaining 91.7% of subjects. Six (4.5%) subjects complained of nasal symptoms during follow-up and subsequent sinusitis was developed in 3% of subjects. An increase in cyst size was associated with development of sinusitis (odds ratio = 45.375). Initial size of cysts >20 mm and bilateral location were significant risk factors for progression (p = 0.019 and p = 0.039, respectively). The majority of PSMCs in this follow-up study were decreased or unchanged and most subjects were asymptomatic. Just observation is enough for most PSMCs. However, those who have a large cyst (>20 mm) or bilateral cysts at initial diagnosis were at risk for disease progression and should be regularly followed.

Association of bronchopneumonia with sinusitis due to Bordetella bronchiseptica in an experimental rabbit model.

An animal model for rhinogenic sinusitis was developed in rabbits naturally colonized with Bordetella bronchiseptica. It was found that ostial occlusion predisposes the sinus to invasion with this opportunistic bacterium and subsequent sinusitis as a result of reduced local host defense. In addition to the inflammatory lesions in the sinus, bronchitis and pneumonia were found in 84% of the experimental rabbits, suggesting that ostial dysfunction can also contribute to infectious disease of the lower respiratory tract. In such a model it is possible to study the significance of asymptomatic carriage of potential pathogens after ostial occlusion.

Paranasal sinusitis after long-term use of topical nasal decongestants.

The aim of this study was to evaluate the incidence of paranasal sinusitis and the histologic changes in the sinus mucosa after long-term administration of topical nasal decongestants, phenylephrine and oxymetazoline. Experimental animals were divided into 3 groups for topical administration for 1 week, 2 weeks, and 4 weeks. Purulent maxillary sinusitis developed in 4 of 10 two-week phenylephrine group, 6 of 10 four-week phenylephrine group, 1 of 10 two-week oxymetazoline group and 3 of 10 four-week oxymetazoline group. Administration of phenylephrine and oxymetazoline for more than 2 weeks caused histologic changes in the maxillary mucosa of the rabbits. Light microscopy showed ciliary loss, epithelial ulceration, inflammatory cell infiltration and edema. The histologic changes were more pronounced with increasing duration of administration of the decongestants. Ciliary loss was more prominent in the 4-week phenylephrine group than in the oxymetazoline group. Dilatation of mitochondria and vacuolization in cytoplasm were prominent in the 4-week groups with both phenylephrine and oxymetazoline. The results of this study suggest that the administration of decongestants may cause ciliary loss with subsequent sinusitis.

Antibiotics and nasal surgery.

Despite the widespread use of prophylactic antibiotics in nasal surgery, the subject has been paid little attention in the literature. In a retrospective analysis of 210 patients who underwent septal surgery or a rhinoplasty, only 5 developed minor infections. Patients undergoing septal surgery or rhinoplasty (174) were evaluated in a randomized sequence, prospectively, to study the efficacy of systemic antibiotic prophylaxis. Only 4 patients developed minor infections; and 173 patients demonstrated no clinical nor radiographic evidence of subsequent sinusitis. The incidence of infectious complications resulting from intranasal surgery is not sufficient to warrant the use of prophylactic antibiotics. Furthermore, proof of their effectiveness in preventing such infections is lacking.