Characteristics of Chronic Maxillary Sinusitis in Patients With a History of Long-term Bisphosphonate Use

Chi Sang Hwang, Chunui Lee, Hee Sung Chae, Chun Han, Hyun Woo Yang, Young Sub Lee, Dong Joon Park

Research output: Contribution to journalArticle

Abstract

Background: Bisphosphonates are widely used as bone stabilizers, which can cause major side effects including bisphosphonate-related osteonecrosis of the jaw (BRONJ) that occurs more frequently in the mandible. Consequently, there is a need for a detailed investigation of BRONJ of the maxilla and, in particular, of involvement of the maxillary sinus. Objective: Our aim was to evaluate the characteristic radiologic and clinical manifestations in patients with maxillary sinusitis and a history of long-term bisphosphonate use. Methods: Between January 2015 and July 2018, 55 patients with symptoms consistent with chronic rhinosinusitis who underwent a paranasal sinus computed tomography (CT) and had a history of >12 months of bisphosphonate therapy were included in the analysis. Results: Radiologically and clinically evident chronic rhinosinusitis was noted in 24 of the 55 patients, of whom more than half (14/24, 58.3%) had BRONJ. The CT studies demonstrated that the maxillary sinus was involved in all 24 patients, characterized by unilateral involvement (70.8%) and bony remodeling in the posterior maxillary region (90.5%). The evidence of osteitis on CT and/or single-photon emission CT was observed in the majority of cases (19/21, 90.5%) and 12 patients (50.0%) had oroantral fistula. However, there were no differences in the clinical appearance of the diseases with respect to the radiologic aspects. Conclusions: Besides its well-known effects on the mandible, long-term bisphosphonate use can also affect the maxillary sinus, with typical clinical and radiological manifestations.

Original languageEnglish
Pages (from-to)500-506
Number of pages7
JournalAmerican Journal of Rhinology and Allergy
Volume33
Issue number5
DOIs
Publication statusPublished - 2019 Sep 1

Fingerprint

Maxillary Sinusitis
Diphosphonates
Bisphosphonate-Associated Osteonecrosis of the Jaw
Maxillary Sinus
Mandible
Oroantral Fistula
Tomography
Osteitis
Paranasal Sinuses
Maxilla
Bone and Bones

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Hwang, Chi Sang ; Lee, Chunui ; Chae, Hee Sung ; Han, Chun ; Yang, Hyun Woo ; Lee, Young Sub ; Park, Dong Joon. / Characteristics of Chronic Maxillary Sinusitis in Patients With a History of Long-term Bisphosphonate Use. In: American Journal of Rhinology and Allergy. 2019 ; Vol. 33, No. 5. pp. 500-506.
@article{048a3a6623654bc089725ddade9dd010,
title = "Characteristics of Chronic Maxillary Sinusitis in Patients With a History of Long-term Bisphosphonate Use",
abstract = "Background: Bisphosphonates are widely used as bone stabilizers, which can cause major side effects including bisphosphonate-related osteonecrosis of the jaw (BRONJ) that occurs more frequently in the mandible. Consequently, there is a need for a detailed investigation of BRONJ of the maxilla and, in particular, of involvement of the maxillary sinus. Objective: Our aim was to evaluate the characteristic radiologic and clinical manifestations in patients with maxillary sinusitis and a history of long-term bisphosphonate use. Methods: Between January 2015 and July 2018, 55 patients with symptoms consistent with chronic rhinosinusitis who underwent a paranasal sinus computed tomography (CT) and had a history of >12 months of bisphosphonate therapy were included in the analysis. Results: Radiologically and clinically evident chronic rhinosinusitis was noted in 24 of the 55 patients, of whom more than half (14/24, 58.3{\%}) had BRONJ. The CT studies demonstrated that the maxillary sinus was involved in all 24 patients, characterized by unilateral involvement (70.8{\%}) and bony remodeling in the posterior maxillary region (90.5{\%}). The evidence of osteitis on CT and/or single-photon emission CT was observed in the majority of cases (19/21, 90.5{\%}) and 12 patients (50.0{\%}) had oroantral fistula. However, there were no differences in the clinical appearance of the diseases with respect to the radiologic aspects. Conclusions: Besides its well-known effects on the mandible, long-term bisphosphonate use can also affect the maxillary sinus, with typical clinical and radiological manifestations.",
author = "Hwang, {Chi Sang} and Chunui Lee and Chae, {Hee Sung} and Chun Han and Yang, {Hyun Woo} and Lee, {Young Sub} and Park, {Dong Joon}",
year = "2019",
month = "9",
day = "1",
doi = "10.1177/1945892419847109",
language = "English",
volume = "33",
pages = "500--506",
journal = "American Journal of Rhinology and Allergy",
issn = "1945-8924",
publisher = "OceanSide Publications Inc.",
number = "5",

}

Characteristics of Chronic Maxillary Sinusitis in Patients With a History of Long-term Bisphosphonate Use. / Hwang, Chi Sang; Lee, Chunui; Chae, Hee Sung; Han, Chun; Yang, Hyun Woo; Lee, Young Sub; Park, Dong Joon.

In: American Journal of Rhinology and Allergy, Vol. 33, No. 5, 01.09.2019, p. 500-506.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Characteristics of Chronic Maxillary Sinusitis in Patients With a History of Long-term Bisphosphonate Use

AU - Hwang, Chi Sang

AU - Lee, Chunui

AU - Chae, Hee Sung

AU - Han, Chun

AU - Yang, Hyun Woo

AU - Lee, Young Sub

AU - Park, Dong Joon

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Background: Bisphosphonates are widely used as bone stabilizers, which can cause major side effects including bisphosphonate-related osteonecrosis of the jaw (BRONJ) that occurs more frequently in the mandible. Consequently, there is a need for a detailed investigation of BRONJ of the maxilla and, in particular, of involvement of the maxillary sinus. Objective: Our aim was to evaluate the characteristic radiologic and clinical manifestations in patients with maxillary sinusitis and a history of long-term bisphosphonate use. Methods: Between January 2015 and July 2018, 55 patients with symptoms consistent with chronic rhinosinusitis who underwent a paranasal sinus computed tomography (CT) and had a history of >12 months of bisphosphonate therapy were included in the analysis. Results: Radiologically and clinically evident chronic rhinosinusitis was noted in 24 of the 55 patients, of whom more than half (14/24, 58.3%) had BRONJ. The CT studies demonstrated that the maxillary sinus was involved in all 24 patients, characterized by unilateral involvement (70.8%) and bony remodeling in the posterior maxillary region (90.5%). The evidence of osteitis on CT and/or single-photon emission CT was observed in the majority of cases (19/21, 90.5%) and 12 patients (50.0%) had oroantral fistula. However, there were no differences in the clinical appearance of the diseases with respect to the radiologic aspects. Conclusions: Besides its well-known effects on the mandible, long-term bisphosphonate use can also affect the maxillary sinus, with typical clinical and radiological manifestations.

AB - Background: Bisphosphonates are widely used as bone stabilizers, which can cause major side effects including bisphosphonate-related osteonecrosis of the jaw (BRONJ) that occurs more frequently in the mandible. Consequently, there is a need for a detailed investigation of BRONJ of the maxilla and, in particular, of involvement of the maxillary sinus. Objective: Our aim was to evaluate the characteristic radiologic and clinical manifestations in patients with maxillary sinusitis and a history of long-term bisphosphonate use. Methods: Between January 2015 and July 2018, 55 patients with symptoms consistent with chronic rhinosinusitis who underwent a paranasal sinus computed tomography (CT) and had a history of >12 months of bisphosphonate therapy were included in the analysis. Results: Radiologically and clinically evident chronic rhinosinusitis was noted in 24 of the 55 patients, of whom more than half (14/24, 58.3%) had BRONJ. The CT studies demonstrated that the maxillary sinus was involved in all 24 patients, characterized by unilateral involvement (70.8%) and bony remodeling in the posterior maxillary region (90.5%). The evidence of osteitis on CT and/or single-photon emission CT was observed in the majority of cases (19/21, 90.5%) and 12 patients (50.0%) had oroantral fistula. However, there were no differences in the clinical appearance of the diseases with respect to the radiologic aspects. Conclusions: Besides its well-known effects on the mandible, long-term bisphosphonate use can also affect the maxillary sinus, with typical clinical and radiological manifestations.

UR - http://www.scopus.com/inward/record.url?scp=85065434047&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85065434047&partnerID=8YFLogxK

U2 - 10.1177/1945892419847109

DO - 10.1177/1945892419847109

M3 - Article

C2 - 31041868

AN - SCOPUS:85065434047

VL - 33

SP - 500

EP - 506

JO - American Journal of Rhinology and Allergy

JF - American Journal of Rhinology and Allergy

SN - 1945-8924

IS - 5

ER -