ANALYSIS OF DIFFERENCES IN PRIMARY CHRONIC RHINOSINUSITIS ENDOTYPES BASED ON OSTEITIS ASSESSED USING GLOBAL OSTEITIS SCORING SCALE (GOSS)

Introduction. Mucosal inflammation in primary chronic rhinosinusitis (CRS) is divided into type 2 and non-type 2 (type 1 and 3). This can induce bone remodeling leading to osteitis. As many as 36-53% of CRS patients have osteitis, which makes CRS difficult to cure. Eosinophilic inflammation is considered to have a more severe impact on bone remodeling than neutrophilic inflammation, but there has been no research thus far that has shown any correlation between endotypes and osteitis in primary CRS. Aim. The aim of this study is to analyze the differences in primary CRS endotypes based on osteitis assessed using the Global Osteitis Scoring Scale (GOSS). Materials and methods. A cross-sectional analytic observational study involving 33 primary CRS patients was conducted. The endotype was determined by measuring the biomarker protein levels in the uncinate process mucosa using the Enzyme-linked Immunosorbent Assay (ELISA) method. Paranasal sinus wall osteitis was evaluated by Computed Tomography (CT) scan and calculated based on GOSS. Results. There was a significant difference in the laterality of paranasal sinus pathology, the presence of nasal polyp, eosinophil cationic protein (ECP) level, and interferon (IFN) γ level between no-to-mild and moderate-to-severe osteitis groups (p<0.05). The mean GOSS in the type 2 group was significantly higher than in the non-type 2 group (p=0.004). Conclusions. Type 2 primary CRS patients have greater osteitis scores than non-type 2 patients, signifying the more profound inflammation of type 2 compared to the non-type 2. It is possible that ECP plays a role in the severity of osteitis in primary CRS patients, though its the exact role requires more research in the future.