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. 2025 Jan 1;17(1):e76730.
doi: 10.7759/cureus.76730. eCollection 2025 Jan.

Clinicopathological Changes of the Maxillary Sinus in Patients With Ethmoidal Polyposis: A Prospective Observational Study

Dillip Kumar Samal  1 , Amit Chirom  2 , Saumyaranjan Mallick  3 , Vikas Gupta  4 , Ganakalyan Behera  4
Affiliations

Clinicopathological Changes of the Maxillary Sinus in Patients With Ethmoidal Polyposis: A Prospective Observational Study

Dillip Kumar Samal et al. Cureus. .

Abstract

Objective of study: To determine the clinical, radiological and histopathological changes in maxillary antrum compared to ethmoid sinuses in patients with chronic sinusitis with nasal polyposis.

Study design: This is a prospective observational study conducted in a tertiary care hospital.

Materials and methods: A total number of 30 primary cases of inflammatory nasal polypi, not responding to conservative measures, were evaluated clinically and radiologically. They underwent endoscopic sinus surgery, and all sinuses were cleared of diseases. Histopathological evaluation of both maxillary sinus and ethmoid sinuses was done and compared.

Results: Among 30 patients with 60 nasal cavities studied, nearly all showed partial or complete opacity of their maxillary antrum and blocked osteomeatal complexes on radiology. But, only a few patients (16.67%) showed frank polypi in their antrum intra-operatively. On histopathology, antral mucosa showed rare involvement, and the submucosa showed variable grades of inflammation, but it was significantly less compared to ethmoids.

Conclusion: Although maxillary antrum gets involved clinically in nearly all polyposis cases, pathological involvement is unlikely compared to ethmoid sinuses. Thus, it indicates a secondary inflammatory change in maxillary sinuses rather than primary involvement.

Keywords: chronic sinusitis; ethmoid polyposis; maxillary sinus; nasal polypi; osteomeatal complex; paranasal sinus.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics Committee, All India Institute of Medical Sciences, New Delhi issued approval IESC/T-313. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Pie chart showing endoscopic staging of patients at presentation.
Figure 2
Figure 2. Bar diagram showing radiological scores of different sinuses: anterior ethmoids, posterior ethmoids, maxillary sinuses and osteomeatal units (using the Lund-Mackay scoring system).
Figure 3
Figure 3. Bar diagram showing intra-operative findings of maxillary sinuses.
Figure 4
Figure 4. Submucosal eosinophilic infiltrations.
(A) <20/high power field (HPF); (B) 20-50/HPF; (C) >50/HPF (haematoxylin and eosin staining on 400 X).
See this image and copyright information in PMC

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