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Changes in chronic rhinosinusitis: A retrospective analysis of computed tomography imaging and inflammatory changes either side of a 5‑year interval

  • Authors:
    • Jun Wang
    • Shikang Xiao
    • Yunping Fan
    • Yunfei Gao
  • View Affiliations / Copyright

    Affiliations: Department of Radiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China, Department of Otolaryngology, The People's Hospital of Rongchang Chongqing, Chongqing 402460, P.R. China, Department of Otolaryngology, The Seventh Affiliated Hospital of Sun Yat‑Sen University, Shenzhen, Guangdong 518107, P.R. China
    Copyright: © Wang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 140
    |
    Published online on: June 17, 2025
       https://doi.org/10.3892/br.2025.2018
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Abstract

Chronic rhinosinusitis (CRS) remains a prevalent and challenging condition characterized by variable clinical presentations and severity. The present study investigated changes in CRS characteristics either side of a 5‑year interval to understand the impact of clinical advancements on disease management. A retrospective analysis was conducted on 120 patients diagnosed with CRS in 2017 and 2023 at The Second Hospital of Shanxi Medical University (Taiyuan, Chian). Standardized computed tomography imaging was performed, and sinonasal inflammation severity was evaluated using Lund‑Mackay (LM) scores. Comparative analyses focused on anatomical variations, mucosal and submucosal features, and patterns of inflammation. Significant reductions in LM scores were observed in 2023 compared with those in 2017, indicating decreased sinonasal inflammation severity. Improvements were most pronounced in the osteomeatal complex (OMC) and frontal sinuses, with asymmetrical changes between the left and right sides. The left OMC and frontal sinus exhibited greater reductions in inflammation, whereas the right side showed less pronounced improvements. Analysis of mucosal thickening revealed a shift from diffuse to localized patterns, with reduced submucosal remodeling and fewer signs of chronic osteitis observed in 2023 compared with that in 2017. Anatomical variations, such as middle turbinate pneumatization and nasal septum deviation, remained unchanged between the two cohorts. This stability suggests that the observed reduction in disease severity may be more likely related to external factors such as earlier detection or evolving clinical practice, rather than anatomical differences. In conclusion, over the past 5 years, a marked reduction in CRS severity has been observed, particularly in regions critical for sinus ventilation and drainage. These findings may reflect broader changes in clinical practice over time, such as increased disease awareness, improved access to diagnostic tools or shifts in general management approaches, although specific treatment strategies or time of presentation were not directly assessed. The results also highlighting persistent asymmetry and inter‑sinus variability. Further prospective studies integrating advanced imaging and molecular techniques are needed to improve understanding of these time trends and refine diagnostic and therapeutic approaches in CRS care.
View Figures

Figure 1

Comparison of total LM scores between
2017 and 2023 cohorts. Boxplots illustrating the distribution of
total LM scores for patients with chronic rhinosinusitis in 2017
(n=60) and 2023 (n=60). (A) Left sinonasal cavity and (B) right
sinonasal cavity LM scores reflecting sinonasal inflammation
severity. Comparison of left and right sinonasal LM scores in the
(C) 2017 and (D) 2023 cohorts. Each bar represents the mean ±
standard deviation. **P<0.01 and
****P<0.0001. ns, not significant; LM,
Lund-Mackay.

Figure 2

Changes in left-sided OMC and
individual sinus scores in patients with CRC. (A) Changes in
left-sided OMC. LM scores of the (B) left maxillary sinus, (C)
sphenoid sinus, (D) anterior ethmoid sinus, (E) posterior ethmoid
sinus and (F) frontal sinus are shown. Each bar represents the mean
± standard deviation. **P<0.01,
***P<0.001 and ****P<0.0001. OMC,
osteomeatal complex; LM, Lund-Mackay.

Figure 3

Changes in right-sided OMC and
individual sinus scores. (A) Changes in left-sided OMC. LM scores
of the (B) left maxillary sinus, (C) sphenoid sinus, (D) anterior
ethmoid sinus, (E) posterior ethmoid sinus and (F) frontal sinus
are shown. Each bar represents the mean ± standard deviation.
*P<0.05 and **P<0.01. OMC, osteomeatal
complex; ns, not significant; LM, Lund-Mackay.

Figure 4

Representative CT images demonstrating
changes in sinonasal inflammation features. CT images from patients
with chronic rhinosinusitis in 2017 and 2023 highlighting
differences in mucosal thickening, submucosal bone changes and
sinus aeration. CT, computed tomography; OMC, osteomeatal
complex.
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Copy and paste a formatted citation
Spandidos Publications style
Wang J, Xiao S, Fan Y and Gao Y: Changes in chronic rhinosinusitis: A retrospective analysis of computed tomography imaging and inflammatory changes either side of a 5‑year interval. Biomed Rep 23: 140, 2025.
APA
Wang, J., Xiao, S., Fan, Y., & Gao, Y. (2025). Changes in chronic rhinosinusitis: A retrospective analysis of computed tomography imaging and inflammatory changes either side of a 5‑year interval. Biomedical Reports, 23, 140. https://doi.org/10.3892/br.2025.2018
MLA
Wang, J., Xiao, S., Fan, Y., Gao, Y."Changes in chronic rhinosinusitis: A retrospective analysis of computed tomography imaging and inflammatory changes either side of a 5‑year interval". Biomedical Reports 23.2 (2025): 140.
Chicago
Wang, J., Xiao, S., Fan, Y., Gao, Y."Changes in chronic rhinosinusitis: A retrospective analysis of computed tomography imaging and inflammatory changes either side of a 5‑year interval". Biomedical Reports 23, no. 2 (2025): 140. https://doi.org/10.3892/br.2025.2018
Copy and paste a formatted citation
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Spandidos Publications style
Wang J, Xiao S, Fan Y and Gao Y: Changes in chronic rhinosinusitis: A retrospective analysis of computed tomography imaging and inflammatory changes either side of a 5‑year interval. Biomed Rep 23: 140, 2025.
APA
Wang, J., Xiao, S., Fan, Y., & Gao, Y. (2025). Changes in chronic rhinosinusitis: A retrospective analysis of computed tomography imaging and inflammatory changes either side of a 5‑year interval. Biomedical Reports, 23, 140. https://doi.org/10.3892/br.2025.2018
MLA
Wang, J., Xiao, S., Fan, Y., Gao, Y."Changes in chronic rhinosinusitis: A retrospective analysis of computed tomography imaging and inflammatory changes either side of a 5‑year interval". Biomedical Reports 23.2 (2025): 140.
Chicago
Wang, J., Xiao, S., Fan, Y., Gao, Y."Changes in chronic rhinosinusitis: A retrospective analysis of computed tomography imaging and inflammatory changes either side of a 5‑year interval". Biomedical Reports 23, no. 2 (2025): 140. https://doi.org/10.3892/br.2025.2018
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