General Medical Information

Chronic Sinusitis

Barbara A. Zeifer

After repeated bouts of acute sinusitis, chronic hypertrophic changes develop, but the mucosal thickening alone cannot be differentiated from acute disease. Long-standing chronic inflammatory disease can produce osteitic changes of the sinus walls that result in bony thickening, a process most common in the sphenoidal sinus. Bony thickening can be a postoperative change most pronounced in the maxillary antrum after Caldwell-Luc antrostomy and mucosal stripping. Less severe bone thickening can be seen in the ethmoidal cavity after endoscopic sinus surgery. Bone erosion can occur with chronic inflammatory disease and often is associated with polyposis. Erosion into the retromaxillary space is extremely unusual and suggests the presence of neoplasia or a mucocele.