Impact of mucosal biofilm and bony osteitis on chronic rhinosinusitis with nasal polyps

Abstract

hronic rhinosinusitis (CRS) is one of the most common inflammation in the upper airway, which often involves the nasal and sinus mucosa. It is a multifactorial and heterogenous disease with unclear etiology and pathogenesis. A variety of factors have been researched to have relations with the pathogenesis of CRS, such as histopathology, inflammatory cell and T cell patterns, tissue remodeling, eicosanoid and IgE production, microorganisms, and epithelial barrier malfunction. CRS is currently classified into two major subgroups: chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP), which have different inflammatory and remodeling patterns. In spite of the maximal medical and endoscopic sinus surgery therapy, there are still 10–20 % CRS patients have persistent and recurrent inflammation, Consequently, ongoing research to better characterize the pathogenesis of CRSwNP with respect to reasons for failure, including factors such as the local immune response, biofilms and the role of osteitis, or inflammation involving bone, which are much less extensively studied.