Perloff J R, Gannon F H, Bolger W E, Montone K T, Orlandi R, Kennedy D W
Department of Otorhinolaryngology--Head and Neck Surgery, University of Pennsylvania, Philadelphia, USA.
Laryngoscope. 2000 Dec;110(12):2095-9. doi: 10.1097/00005537-200012000-00023.
OBJECTIVES/HYPOTHESIS: To study the effects of bone involvement in experimentally induced sinusitis and the effect of involved bone on the overlying mucosa.
Animal study.
Sinusitis was induced unilaterally with Pseudomonas aeruginosa in the maxillary sinus of 19 New Zealand white rabbits. At 6 weeks, the pathogenic organism was confirmed by culture, and a segment of the bone from the medial wall of the sinus implanted in a submucosal pocket in the opposite sinus. The rabbits were killed at predetermined time intervals up to 13 weeks from sinusitis induction, and en bloc sinus sections were decalcified and stained.
The implanted bone reabsorbed partially or totally in all specimens. However, the study revealed clear histological evidence of bone involvement adjacent to the infected sinuses and the bony changes extended to the noninfected side in all specimens. The histological findings were identical to those seen in chronic osteomyelitis.
This study demonstrates the ability for pseudomonal sinusitis, at least in the presence of surgical intervention, to involve bone at a distance from the site of primary infection in the absence of intervening mucosal disease. If confirmed with additional organisms and models, these findings have significant implications for the therapeutic management of chronic sinus disease.
目的/假设：研究实验性诱导鼻窦炎时骨受累的影响以及受累骨对其上方黏膜的影响。
动物研究。
在19只新西兰白兔的上颌窦中单侧接种铜绿假单胞菌诱导鼻窦炎。6周时，通过培养确认致病微生物，并将窦内侧壁的一段骨植入对侧窦的黏膜下袋中。在诱导鼻窦炎后的13周内，按照预定的时间间隔处死兔子，并将整块鼻窦切片进行脱钙和染色。
所有标本中植入的骨部分或全部被吸收。然而，该研究揭示了感染鼻窦邻近部位骨受累的明确组织学证据，并且所有标本中骨改变均扩展至未感染侧。组织学表现与慢性骨髓炎所见相同。
本研究表明，至少在存在手术干预的情况下，铜绿假单胞菌性鼻窦炎能够在无中间黏膜疾病的情况下累及远离原发感染部位的骨。如果通过更多的微生物和模型得到证实，这些发现对慢性鼻窦疾病的治疗管理具有重要意义。
