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The pathology of chronic sinusitis has been changing in recent years in Japan. This has been attributed to the increasing frequency of the association of sinusitis with allergic rhinitis and/or bronchial asthma. To investigate the pathology of chronic sinusitis and the changes in the pathology over the years, the inflammatory cells infiltrating the paranasal sinus mucosa were counted in cases of chronic sinusitis with different disease durations. The number of inflammatory cells infiltrating the ethmoidal sinus mucosa was also comparatively assessed according to the presence or absence of association of the chronic sinusitis with bronchial asthma and/or perennial allergic rhinitis. Specimens of the paranasal sinus mucosa from adult patients with chronic sinusitis were collected at the time of paranasal sinus surgery. Fourteen, 16 and 16 patients, respectively, were selected randomly from among patients treated between 1980 and 1985, 1990 and 1995, and 2000 and 2004, for a comparative assessment. The patients treated between 2000 and 2004 were divided into the following groups for a comparative assessment: chronic sinusitis associated with aspirin-induced asthma (Group I:6 patients), chronic sinusitis associated with bronchial asthma (other than aspirin-induced asthma) (Group II: 11 patients), chronic sinusitis associated with perennial allergic rhinitis (Group III: 16 patients), and chronic sinusitis alone (Group IV: 8 patients). The lamina propria just beneath the epithelial layer was observed under a light microscope, and the number of infiltrating inflammatory cells per visual field atX400 magnification was counted. An increase in the number of eosinophils infiltrating the paranasal sinus mucosa and decrease in the number of infiltrating neutrophils and lymphocytes were observed in the patients treated in the later years, as compared with the observations in specimens from patients treated in the 1980's. The number of eosinophils was significantly larger in the patients in whom the chronic sinusitis was associated with bronchial asthma (Groups I and II) as compared with that in those in whom the condition was not associated with asthma (Groups III and IV). There were no significant differences in the number of eosinophils between Group I and Group II or between Group III and Group N. The number of mast cells was also larger in the patients in whom the chronic sinusitis was associated with bronchial asthma (Groups I and II) , similar to the case for the eosinophils.

The Characteristics of Chronic Sinusitis as Assessed by Examination of Inflammatory Cells in the Mucosa