Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2020 Aug;130(8):E460-E468.
doi: 10.1002/lary.28639. Epub 2020 Apr 3.

Impact of Paranasal Sinus Surgery in Granulomatosis With Polyangiitis: A Longitudinal Computed Tomography Study

Sigrun S Holme  1   2 , Jon M Moen  1 , Karin Kilian  2   3 , Heidi B Eggesbø  1 , Øyvind Molberg  2   3
Affiliations
Observational Study

Impact of Paranasal Sinus Surgery in Granulomatosis With Polyangiitis: A Longitudinal Computed Tomography Study

Sigrun S Holme et al. Laryngoscope. 2020 Aug.

Abstract

Objectives/hypothesis: Severe chronic rhinosinusitis (CRS) in patients with granulomatosis with polyangiitis (GPA) failing medical therapies can be treated with paranasal sinus surgery. Whether this surgery protects from progressive sinonasal damage remains unknown. Here, we aimed to analyze time-dependent relations between sinus surgeries and computed tomography (CT) imaging features in the CRS of GPA.

Study design: Longitudinal observational study.

Methods: We assessed CRS features including bone thickening by global osteitis scoring scale, bone erosions, and mucosal thickening by Lund-Mackay scores in serial paranasal sinus CT scans (742 CT scans in total) from a cohort of 127 well-characterized GPA patients. Data on sinonasal surgical procedures were from a mandatory national registry and from chart review. We defined the time from baseline CT to last CT as the study observation period in each patient. Datasets were analyzed by linear mixed models.

Results: We found that 23/127 cohort patients had one or more paranasal sinus surgical procedures, and 96% of these (22/23) had osteitis by CT after surgery. In patients with nasal surgery alone or no surgery, we identified osteitis in 7/11 (64%) and 45/93 (48%), respectively. During the observation period of a median of 5 years, 38 patients had progression of their sinus osteitis, with the highest annual osteitis progression rates observed around the time of surgery.

Conclusions: In this cohort, paranasal sinus surgery was associated with prevalence, severity, and progression rate of sinus osteitis, indicating that sinus surgery does not reduce the bone damage development in the CRS of GPA.

Level of evidence: 4 Laryngoscope, 130: E460-E468, 2020.

Keywords: Granulomatosis with polyangiitis; computed tomography; longitudinal study; osteogenesis; paranasal sinuses.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

BIBLIOGRAPHY

    1. Koldingsnes W, Nossent H. Epidemiology of Wegener's granulomatosis in northern Norway. Arthritis Rheum 2000;43:2481-2487.
    1. Mohammad A, Jacobsson L, Mahr A, Sturfelt G, Segelmark M. Prevalence of Wegener's granulomatosis, microscopic polyangiitis, polyarteritis nodosa and Churg-Strauss syndrome within a defined population in Southern Sweden. Rheumatology 2007;46:1329-1337.
    1. Watts RA, Al-Taiar A, Scott DGI, Macgregor AJ. Prevalence and incidence of Wegener's granulomatosis in the UK general practice research database. Arthritis Rheum 2009;61:1412-1416.
    1. Watts R, Lane S, Hanslik T, et al. Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies. Ann Rheum Dis 2007;66:222-227.
    1. Abdulkader R, Lane SE, Scott DG, Watts RA. Classification of vasculitis: EMA classification using CHCC 2012 definitions. Ann Rheum Dis 2013;72:1888.

Publication types