Incidence of chronic hyperostotic rhinosinusitis in patients undergoing primary sinus surgery compared to revision surgery

HYPOTHESIS: The incidence of chronic hyperostotic rhinosinusitis has been underreported due to poor recognition of the disease process. The surgical management of chronic hyperostotic rhinosinusitis with prolonged pre and post-operative antibiotic therapy can alter clinical course of the disease process. STUDY DESIGN: A prospective study of 40 patients based at two teaching tertiary care institutions. MATERIAL AND METHODS: CT scans of twenty patients (ten undergoing primary sinus surgery and ten undergoing revision sinus surgery) were randomly selected from each institution and reviewed by an independent radiologist for evidence of hyperostosis and compared to original reading of the CT scans. RESULTS: The finding of sinus hyperostosis is rarely reported by the radiologist on the sinus CT scan where the focus is always on mucosal disease. The incidence of sinus hyperostosis is higher, in patients undergoing revision sinus surgery than patients undergoing primary sinus surgery. CONCLUSION: Sinus hyperostosis is not an uncommon finding in chronic refractory sinusitis which may require long term intravenous antibiotic therapy in conjunction with surgery to provide symptomatic relief.