Sinonasal bony changes in nasal polyposis: prevalence and relationship to disease severity

J Laryngol Otol. 2013 Aug;127(8):755-9. doi: 10.1017/S0022215113001461. Epub 2013 Jul 18.

Abstract

Background: Nasal polyposis is characterised by opacification of the nasal cavities, paranasal sinuses and ostiomeatal complexes on computed tomography scanning. Sinonasal bony changes have been reported as disease sequelae.

Objectives: To assess the prevalence of sinonasal bone expansion, erosion and thickening in patients with nasal polyposis, and to correlate disease severity with the prevalence of bony changes.

Methods: A retrospective radiological study was conducted comprising pre-operative computed tomography scans of 104 patients with nasal polyposis and scans of 44 age- and gender-matched individuals (control group) without sinonasal disease. Lund–Mackay scores and bony changes were quantified.

Results: Ninety-three per cent of the study group scans showed sinonasal bony change, with no changes in the control group. Radiological severity of nasal polyposis correlated positively with the prevalence of bony changes (rs = 0.31; p < 0.01).

Conclusion: Sinonasal bony changes were common in the study group. This highlights the importance of pre- and intra-operative imaging, which can help to prevent intra-operative complications. As bony changes may mimic invasive disease, the importance of histological assessment of polyps is emphasised.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bone and Bones / diagnostic imaging*
  • Case-Control Studies
  • Child
  • Chronic Disease
  • Female
  • Humans
  • Intraoperative Period
  • Male
  • Middle Aged
  • Nasal Polyps / complications*
  • Nasal Polyps / diagnostic imaging*
  • Nasal Polyps / pathology
  • Paranasal Sinus Diseases / diagnostic imaging*
  • Paranasal Sinus Diseases / pathology
  • Paranasal Sinuses / diagnostic imaging
  • Preoperative Care
  • Prevalence
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*
  • Young Adult