Distribution Analysis of Goblet Cells in Atrophic Rhinitis and Rhinitis Sicca with Special Reference to Impression Cytology Findings / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The goblet cells secrete mucus in response to a wide variety of stimuli, playing an important role on increased nasal secretion. One of the main symptoms and signs in atrophic rhinitis and rhinitis sicca is a crust formation that fill up the nasal cavity, obstructing the nasal cavity. It has been suggested to be caused by mucosal atrophy and decreased nasal secretion. Nevertheless, distribution of goblet cells in both rhinitis has not been evaluated in the whole surface of inferior turbinate. The present study was to investigate the distribution density of goblet cells in the inferior turbinate of both rhinitis patients. MATERIALS AND METHODS: Impression cytology, using nitroscellulose membrane, was performed in inferior turbinates of normal control, rhinitis sicca and atrophic rhinitis patients. The membrane was fixed in the fixative and then stained with Alcian Blue. RESULTS: The membrane stained with Alcian Blue defined the whole distribution of goblet cells which was present in the medial surface of the inferior turbinate. In normal nasal turbinates, goblet cells were evenly distributed, and did not differ in their distribution density. In rhinitis sicca, goblet cells were irregularly distributed, showing a moth-eaten appearance in the anterior and mid-portion, whereas they gained the same distribution as the normal turbinate for the posterior portion. Atrophic rhinitis had a few number of goblet cells even in the mid-and posterior portion of the inferior turbinate. CONCLUSION: Impression cytology proves to be a reliable and efficient method for the evaluation of goblet cells distributed in the inferior turbinates. The present study demonstrated that goblet cells decreased in their number in inferior turbinates of both rhinitis, suggesting their major role in decreased nasal secretion.

Ultrastructural Changes of Mucous Blanket in Chronic Ethmoiditis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: he mucous blanket as a smooth layer riding on the top of cilia in the respiratory mucosa provides the airway fluidity and protection from exogenous materials. However, the depth of the periciliary fluid layer is critical for the interaction between the cilia and mucus as decreased depth of the periciliary fluid layer could disturb the mucociliary transport. The purpose of this study is to investigate the ultrastructural changes of mucous blanket in the inflammatory mucosa of posterior ethmoid. MATERIALS AND METHODS: We evaluated the ultrastructural changes of ethmoid mucous blanket using the transmission electron microscope (5 normal posterior ethmoid sinus mucosa and 5 posterior ethmoiditis mucosa). RESULTS: Normal ethmoid maintained two layers of mucous blanket, but the mucous blanket from posterior ethmoiditis showed decreased periciliary fluid layer and increased mucous layer. CONCLUSION: Decreased periciliary fluid layer due to increased mucous layer in posterior ethmoiditis cause inactive ciliary beat and therefore can impair mucociliary transport. On the other hand, early drainage of mucus secretion in posterior ethmoiditis may improve the mucociliary transport.

Laser Assisted Partial Adenotonsillectomy in Children / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In children, adenotonsillectomy is performed for treating recurrent tonsillitis, mouth breathing and sleep disorder. However, there are some complications associated with the complete removal of the tonsil and adenoid. The conventional method involving dissection and snare techniques used for adenotonsillectomy has been the subject of debate over its indications and appropriate time for surgery, since it removes most of the tonsil tissues and may have destructive effect on the local defense mechanism. The aim of this study was to analyze the results of laser assisted partial adenotonsillectomy by using KTP-532 laser to preserve minimal amount of tonsil tissue needed for the local defense mechanism. MATERIALS AND METHODS: Sixty cases of laser assisted partial adenotonsillectomy, and sixty cases of conventional adenotonsillectomy with dissection and snare techniques were examined. RESULTS: There were no differences regarding the recurrence rate, improvement of symptoms, and degree of postoperative pain between the laser partial adenotonsillectomy group and the conventional groups. There were less incidence of preoperative bleeding and postoperative scar formation in the laser partial adenotonsillectomy. CONCLUSION: Compared to the conventional method, the laser assisted partial adenotonsillectomy has a similar incidence of postoperative result but a low incidence of preoperative complications such as bleeding. It also preserves minimal tonsil tissues responsible for local defense mechanism. We suggest that the laser assisted partial adenotonsillectomy is an attractive surgical method in children.

Regional Differences in the Distribution of Calcitonin-Gene-Related-Peptide-Immunoreactive Nerve Fibers in the Nasal Epithelium of Rat Pup, Guinea Pig, and Cat

The distribution pattern of calcitonin gene-related peptide immunoreactive (CGRP-IR) nerve fibers in the epithelial layer was investigated with immunohistochemistry on serial sections of the whole nasal cavities of rat pups, guinea pigs and cats. The distribution pattern of CGRP-IR nerves beneath and within the epithelium demonstrated considerable regional differences in the nasal cavities of the laboratory animals cited above, and appeared to vary according to different compartments of the nasal cavity. In the rat pups, the CGRP-IR nerve fibers were densely distributed in the nasal epithelium lining both surfaces of the nasal septum and the medial sides of the naso-and maxillo-turbinates, whereas the distribution was less dense at the lateral sides of both turbinates and the lateral nasal wall. In particular, these nerve fibers were heavily concentrated in the inferior surface of the nasoturbinate and the superior surface of the maxilloturbinate, where large numbers of nerve fibers were found extending toward the luminal surface from the basal plexus. These features were also noted in the nasal cavity of the guinea pig and cat. The present observations show that one cannot consider the whole nasal cavity as a uniformly innervated region when interpreting the significance of the mucosal CGRP-innervation. Furthermore, in relation to the sensory role of CGRP-IR nerve, these results suggest that the different regions of the nose may have varying significance with respect to the basic protective function of this organ.