Bony complications of chronic sinusitis

ABSTRACT

To study bony complications of sinonasal disease and its varied manifestations. In this five year retrospective study, cases with bony complications from 2003 to 2007 were collected and their records evaluated. Twenty cases were identified with bony complications. Maxilla was most common bone affected. Five patients were diagnosed as having acute osteomyetitis [35%]; an equal number were diagnosed as having chronic osteomyelitis of which one had a fistula on the cheek and one had fistula due to tuberculosis. Odontogenic infections and chronic sinusitis each gave rise to two cases with osteomyelitis of the palate and maxilla. Chronic sinusitis was the main cause of frontal bone osteomyelitis in two cases, one of which had a discharging fistula in left frontoethmoid region displacing eye. Fungal sinusitis led to destruction of lamina papyracea. Acute osteomyelitis responded to antibiotics. Polymicrobial infection is common, antibiotics are indicated initially. Surgery is considered when an abscess is revealed by CT and if it deteriorates clinically. Results suggest that FESS is effective for diagnosis and treatment of complications but can be combined with conventional surgery which is effective in management of refractory sinusitis