Comparative Study Of Bone Resorption Of Bacterial Nasal - Sinusitis And Fungal Rhinosinusitis In Rabbit Model

Objective:1. To observe the regional anatomy of rhino-sinus in rabbits and its performance through CT imaging, and to discuss the feasibility of applying a rabbit model to the study of animal rhino-sinusitis.2. To establish the rabbit model of bacterial rhino-sinusitis and observe the bone remodeling changes of dynamic CT images and pathological morphology. To analyze the bacterial rhino-sinusitis changes over time that course of the evolution of bone remodeling and their characteristics performance.3. To establish the rabbit model of fungal rhino-sinusitis and observe the bone remodeling changes of dynamic CT images and pathological morphology. To analyze the fungal rhino-sinusitis changes over time that course of the evolution of bone remodeling and their characteristics performance.4. To discuss the differences of the course evolution and sinusitis bone remodeling in the pathogenesis between bacterial sinusitis and fungal sinusitis by analyzing the two groups’CT images and histopathologic features of morphological changes.Methods:1.40New Zealand white rabbits were selected and scanned by the Discovery CT750HD in sinus coronal and horizontal routine in order to exclude congenital nasal sinus disease. The rabbits were divided into four groups:the Anatomy group5(10sides);the control group5(10sides); bacterial rhino-sinusitis group15(30sides); fungal rhino-sinusitis group15(30sides).2. he rabbit sinusitis model were established by scratching maxillary sinus mucosa, filling the sinuses and sinus blockage. Sinonasal endoscopy, CT scan, mucous secretion culture and bone biopsy done were taken in2,4,8and12weeks respectively.3. Radiographic and histological assessment:rabbit nasal sinus CT assessments to osteoarthritis, bone destruction, soft tissue involvement were as the main indicators. Histopathology were stained with HE, tartrate-resistant acid phosphatase staining and alkaline phosphatase staining. After staining the mucosal inflammation of ethmoid sinus, histological changes of mucoperiostal and reshape bone activity were observed with the microscope. And make the appropriate score about the related organizations accordingly.4. Statistical analysis:Rank sum test for multi-group level data analysis were rated on mucosal inflammation, bone tissue mucoperiostal score and bone remodeling score. P <0.05was considered statistically significance, P<0.01considered statistically significant difference. Mucosal inflammation in the experimental group, mucoperiostal and bone tissue and bone remodeling were rated PEARSON correlation analysis. R is the absolute value of approximately which is much closer to1the correlation much better. It is statistically significant when P<0.05. It is statistically significant difference when P<0.01.Results:1. The nasal septum is located on both sides of the nasal cavity. The lateral wall of rabbit nasal is composed of maxillary turbinate, middle turbinate, the inside of the middle turbinate and inferior turbinate. The maxillary sinus cavity is the largest one and ethmoid sinus, sphenoid sinus and frontal sinus is relatively much smaller. All these sinuses are paired and symmetrical.2. Bacterial sinusitis group of related pathological inflammation results:using juvenile and testing results comparing adjacent time periods P>0.05was not statistically significant, the interval time comparing P<0.05, comparable. Maxillary bone wall pathology showed chronic destructive changes in both bone destruction and proliferation4weeks ago. The first four weeks, compared with the first eight weeks of bone destruction and proliferation P<0.01, with a statistically significant. The part of this time segment of bone remodeling of the accelerating phase. Other adjacent time periods P values were greater than0.05.3. Fungal sinusitis group of related pathological inflammation results:using juvenile and testing results in the first two weeks comparing with the first four weeks P<0.05, statistically significant. Bone pathology of inflammation in the fourth weeks comparing with the eighth week, P=0.008<0.01, with statistically significant. Mucoperiostal inflammation in the first2weeks to4weeks inflammatory symptoms rapidly developed. After4weeks a chronic inflammatory process was showed. The pathological bone changes gradually increased over time, but pathological changes in bone were obviously from the first4weeks to8weeks. There were no statistically significant between other neighboring comparative periods.4. Compared to the two groups at the same time sinusitis fungal sinusitis score relatively high, while taking advantage of juvenile and pairwise comparison test results:sinus mucosal changes, the first two weeks P>0.005;4weeks P=0.046, P0.005;8weeks P=0.029, P<0.05;12weeks P=0.014, P<0.05. Mucosal inflammation in two weeks was not comparable, then fungal sinusitis severe mucosal damage was more serious than bacterial sinus inflammation. Mucoperiosteal changes: the first two weeks P>0.05;4weeks P=0.0412, P<0.05;8weeks P=0.004, P<0.01; 12weeks P>0.05, fungal sinusitis severe mucosal damage was more serious than bacterial sinus inflammation from4weeks to8weeks. Bone changes:the first two weeks P>0.05;4weeks P>0.05;8weeks P=0.046, P<0.05;12weeks P=0.023, P <0.05, there was no difference between two groups in the early periods, but after four weeks the fungal sinusitis was more serious than bacterial sinusitis. By using PEARSON correlation analysis, to study the two groups of sinus mucosal inflammation and mucoperiostal and pathological changes in bone and bone remodeling activity relationships, the experimental results show that fungal nose-the degree of inflammatory infiltration of the mucosa of the maxillary sinus and mucoperiostal and bone tissue pathology score (R=0.813,P<0.01), bone remodeling activity (R=0.796, P<0.01) significantly correlated, namely the group of mucosal inflammatory higher the rating, mucoperiostal and pathological bone tissue and bone remodeling activity score ratings are higher. The degree of bacterial sinusitis group with mucosal inflammatory infiltration and bone mucoperiostal pathological score (R=0.781, P<0.01), bone remodeling activity (R-0.814, P<0.01), which is the comparison of the same group correlated significantly.Conclusions:1. The rhino-sinus in rabbit is displayed clearly in CT scan. The anatomical location of rabbit is similar to that of human; however, the maxillary sinus of rabbit is greater than that of human correspondingly, which is suitable for operating and applying to surgical anatomy and imaging analysis. The rabbit model of rhino-sinus can be applied to simulate human rhino-sinusitis.2. Fungal nose-bacterial sinusitis and nasal-sinusitis radiological and histopathological observations were bone destruction, absorption, absent, proliferation and remodeling fibrosis phenomenon; the changes of fungal sinusitis bone were chronic persistent inflammation, and bone destruction is more important than the degree of bacterial sinusitis; fungal nose-bacterial sinusitis and nasal-inflammation of maxillary sinus mucosa infiltration mucoperiostal and pathological changes in bone, bone remodeling activity have obvious relevance; The two disease models in the mucosal infection two weeks already have bone changes, the fourth weeks beginning accelerated bone destruction or remodeling, fungal infections with time and was continued to intensify, and bacterial in the eighth weeks after infection to bone destruction or remodeling was in basic quiescent.