Changes of extracellular matrix of nasal mucosa in guinea pig model of prolonged allergic-induced rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The aim of this study was to explore the changes of the extracellular matrix in nasal mucosa by a guinea pig model of prolonged allergic-induced rhinitis.@*METHOD@#Thirty-two male Hartley guinea pigs were randomly divided into four groups: allergen challenged groups (Group 2 w, Group 6 w and Group 12 w) and a control group. Ovalbumin-sensitized guinea pigs were repeatedly challenged with allergen twice a week from 2 weeks to 12 weeks. Matched control groups were challenged with physiological saline. Nasal mucosa were obtained from the animals killed. Hematoxylin-Eosin, Masson's trichrome, and immunohistochemical staining against transforming growth factor-beta1 (TGF-beta1), Collagen III and Collagen I were performed to nasal mucosa.@*RESULT@#(1) Pathological examination showed obvious infiltration of eosinophils and the enlarged thickness of epithelial layer of nasal mucosa in the experiment groups. (2) The area ratios of blue stained in the extracellular matrix of nasal mucosa were increased. The area ratios of blue stained were statistically different in Group 6 w and Group 12 w compared with the control group. (3) The increasing absorbance of TGF-beta1 were statistically different in the experiment groups with the control group. The absorbance of Collagen III and Collagen I showed a rising trend along prolonged allergen challenged in the experiment groups.@*CONCLUSION@#Prolonged allergen challenge and the inflammation of nasal mucosa, can lead to the increasing of the inflammation relevant factors and the deposit of collagen in the extracellular matrix of nasal mucosa.

Skin prick testing versus immumofluorescence testing for mites allergens / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the characteristics of skin prick test (SPT) and immumofluorescence method (IFM) in detecting the atopy of dermatophagoides pteronyssinus (Dp) and dermatophagoides farinae (Df)and explore the relationship of them.@*METHOD@#Four hundred and ninety-one patients with two or more symptoms of nasal obstruction,itching, sneezing and rhinorrhea received SPT and serum specific IgE detection using IFM.@*RESULT@#SPT was more sensitive than IFM in detecting the atopy of Dp and Df (P < 0.05). If using the IFM as the gold standard, the sensitivity of SPT was all above 95% with the specificity a little bit lower than 80%. These two methods had a positive correlation in detecting the atopy of Dp and Df (r = 0.779, 0.776; P < 0.01). The sIgE concentrations of these two mites were highly correlated with each other (r = 0.954, P < 0.01), the SPT was highly correlated with each other (r = 0. 946, P < 0.01).@*CONCLUSION@#SPT was more sensitive than IFM in detecting the atopy of Dp and Df. In most cases, SPT can replace IFM to detect patients' allergia on mites. Besides, it is good enough to detect either of the serum specific IgE concentrations of Dp and Df.

Prolonged allergen challenge in a guinea pig model of allergic rhinitis leads to nasal mucosa remodeling / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The aim of this study was to use a guinea pig model of prolonged allergic-induced rhinitis to characterize the feature of nasal mucosa remodeling.@*METHOD@#Forty-eight male Hartley guinea pigs were randomly divided into six groups: allergen challenged groups (Group OVA(2w) , Group OVA(6w) and Group OVA(12w)) and control groups respectively (Group Sal(2w), Group Sal(6w) and Group Sal(12w)). Each group had 8 guinea pigs. To develop a guinea pig model of nasal mucosa remodeling, ovalbumin-sensitized guinea pigs were repeatedly challenged with allergen twice a week from two weeks to 12 weeks. Matched control groups were challenged with physiological saline. Nasal lavage was performed 24 hours after the last intranasal challenge. Then nasal mucosa were obtained. HE, AB-PAS, MT, and immunohistochemical staining against transforming growth factor-beta1 (TGF-beta1) were performed. Eosinophil cationic protein (ECP) and OVA-special IgE (OVA-sIgE) were detected by ELISA in nasal lavage fluid.@*RESULT@#(1) The levels of OVA-sIgE in nasal lavage fluid in Group OVA(6w) and Group OVA(12w) were significantly different from Group OVA(2w), while the levels of ECP had no significant difference among the experiment groups. The levels of OVA-sIgE and ECP in experiment groups were significantly different from control groups respectively (P < 0.01). (2) Grade 0 and Grade 1 of epithelial damage were significantly different in Group OVA(6w) and Group OVA(12w) when compared with from Group OVA(2w) (P < 0.01). At the same time, Grade 0 and Grade 1 of epithelial damage were statistically different in the experiment groups when compared with the respectively control groups (P < 0.05). (3) Goblet gland hyperplasia and collagen deposit within the extracellular matrix (ECM) were easily found in Group OVA(6w) and Group OVA(12w) compared with Group OVA(2w) (P < 0.01). The number of goblet gland and the ratio of collagen deposit were statistically more in Group OVA(6w) and Group OVA(12w) than in Group Sal(6w) and Group Sal(12w) (P < 0.05). That feature of the ratio of collagen deposit did not show in Group OVA(2w) versus Group Sal(2w). (4) Increased TGF-beta1 expressions were observed in Group OVA(6w) and Group OVA(12w) compared with Group OVA(2w) (P < 0.01). Those increasing expressions were also observed in experiment groups rather than in the respectively control groups (P < 0.01).@*CONCLUSION@#Epithelial damage, goblet cells hyperplasia and collagen deposition in ECM were observed as the features of remodeling in this guinea pig model of allergic rhinitis under prolonged allergen challenge. Epithelial damage, excessive expression of related cytokines and enhancement activity of enzymes were observed in early time after challenge of allergen. The features of goblet cells hyperplasia and collagen deposition in ECM were observed at a later stage.

Detection of exhaled nitric oxide of healthy in Nanjing / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To determine the normal level of nitric oxide through mouth and nose in healthy adult people. From it the normal values were obtained to provide theory support for the prevention and cure of breathe system diseases, such as asthma, allergic rhinitis and so on.@*METHOD@#One hundred and eighty two healthy nanjing adults were recruited,including 89 males and 93 females. NIOX system was used to obtain the values of exhaled NO through mouth and nose. The relativity between NO and gender, age, height, body mess index, time, ambient NO were analyzed with multiple linear regression and correlation.@*RESULT@#Exhaled NO values were (17 +/- 7) ppb and correlated significantly with height and age. Regression equation: Y (FENO) = -65.784 + 0.102X1 (age) + 0.442X2 (height), P < 0.05. NNO values were (79 +/- 35) ppb.@*CONCLUSION@#FENO normal values and NNO normal values are easy to obtain and have good compliance and high sensitivity, which correlated with height, age, et al.

Fabrication of Allogenic Cartilage in A Tube Lined with Epithelium and A Novel Scaffold / 听力学及言语疾病杂志

Objective To study the feasibility of engineering cartilage tissue in a tube lined with epithelium and implanting allogenic chondrocytes into a novel scaffold consisting of chitosan nonwoven cloth coated with poly (DL-lactide-co-glycolide)(PLGA).The focus of the present study is to explore a new way of repairing laryngeal and tracheal defects.Methods Allogenic chondrocytes were obtained from the auricles of 1-month-old rabbits.After being cultured in vitro for three to four passages,the cells were implanted into the scaffolds to form composite grafts and then transplanted into the rabbits.After 6,12,and 18 weeks,the general,histological characteristics were investigated.Results The cobweb-like matrix was observed approximately 1 week after the chondrocytes had been implanted into the scaffolds.At 6 weeks,the matrix was secreted,and there were immature chondrocytes in the grafts.At 12 weeks,the allogenic cartilage in the tube lined with epithelium had been created.Chondrocytes were almost mature and the lacunae had formed.At 18 weeks,the neocartilage was similar to native cartilage.Conclusion It is feasible to fabricate allogenic cartilage in a tube lined with epithelium by implanting allogenic chondrocytes into a novel scaffold made of chitosan nonwoven cloth coated with PLGA.

Application of frontal drill in revision endoscopic frontal sinus surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the application of frontal drill in revision endoscopic frontal sinus surgery.@*METHOD@#The clinical data of 11 adult patients (18 sides) suffering from chronic recurrent frontal sinusitis were analyzed retrospectively. The patients received revision endoscopic frontal sinus surgery with frontal drill because of difficulty in confirming ostia under endoscope. Postoperatively all cases were followed up to evaluate the efficacy.@*RESULT@#The ostia of frontal sinus were successfully opened with this method in all cases, and no serious complications occurred except hemorrhage due to injury of anterior ethmoidal artery in 1 case. After 7 to 35 months follow-up postoperatively, the symptoms vanished in all cases and none recurred. The endoscopic examinations showed well-opening of frontal sinus ostia.@*CONCLUSION@#Localization of frontal ostium with frontal drill is a simple, convenient, safe and effective accessorial method for revision endoscopic frontal sinus surgery.

Diagnosis of obstructive level in pharynx with obstructive sleep apnea hypopnea syndrome with multiple detector-row spiral CT / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the diagnostic significance of multiple detector-row spiral CT(MSCT) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).@*METHOD@#Sixty-seven patients with OSAHS and 40 volunteers were scanned. The CT imagings from the nasopharyngeal floor to the glottis obtained. The relevant dimensions of area, diameter, thickness of retropharyngeal tissue were measured in some regions in imagings including nasopharynx, oral pharynx and hypopharynx, as well as the narrowest region in pharynx.@*RESULT@#1) The values of area, left-right diameter and front-back diameter of oral pharyngeal imagings of patients with OSAHS were narrowest regions which were (133.5 +/- 32. 9) mm2, (12.5 +/- 2.0) mm, (10.4 +/- 1.8) mm respectively. The value of above parameters of oral pharyngeal imagings of volunteers were (238.5 +/- 46.5) mm2, (20.4 +/- 3.1) mm, (21.1 +/- 4.0) mm respectively. The values of two groups had marked difference by statistics (P< 0.01). 2) The narrowest regions were located in oral pharynx in the imagings of 58 patients with OSAHS, which located in soft palate site in 19 patients, in oral pharynx site in 11 patients and in retro-lingua site in 28 patients. The narrowest regions were located in nasopharynx in the imagings of 3 patients. None of the narrowest region was found in hypopharynx. The narrowest regions, which all located in oral pharynx, were measured in the imagings of 24 volunteers. 3) The values of area, left-right and front-back diameter of the narrowest regions of imaging of 58 patients with OSAHS among 67 patients were (75.6 +/- 17.9) mm2, (10.6 +/- 2.1) mm, (6.9 +/- 1.0) mm respectively. The values of bove parameter of the most narrowest regions of imagings of volunteer were (187.3 +/- 35.6) mm2, (21.4 +/- 4.3) mm, (15.6 +/- 2.7) mm respectively. There were significant difference in statistics among the data of these groups (P < 0.01).@*CONCLUSION@#The imagings of MSCT may provide accurate diagnosis in OSAHS. Patients with OSAHS always had anatomically narrow in pharynx, especially in oral pharynx.

The study of resilience of oral pharyngeal wall in patients with obstructive sleep apnea hypopnea syndrome applied with multiple detector-row spiral CT / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the resilience of oral pharyngeal wall in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).@*METHOD@#Applied with multiple detector-row spiral CT, 24 patients with OSAHS and 10 volunteers were scanned from nasopharynx to hypopharynx under the normal breathing state and the breathing state of Muller maneuver. The relevant dimensions of area and thickness of retropharyngeal soft tissue were measured in some level in imagings including the soft palatal level, the lingual level and the epiglottic level, then the resilience of these levels were calculated according to the above data.@*RESULT@#The values of resilience of oral pharyngeal wall were larger in patients with OSAHS than those in the volunteers. The difference of the values of resilience in soft palatal level and lingual level was statistically significant (P < 0.01). The values of thickness of retropharyngeal soft tissue in the soft palatal level, the lingual level and the epiglottic level were respectively (7.5 +/- 2.2) mm, (4.8 +/- 1.3) mm, and (2.3 +/- 0.2) mm. There was a significant difference in the thickness in soft palatal level between the patients with OSAHS and the volunteers (P < 0.01). The indexes of Pearson correlation of between the thickness of retropharyngeal soft tissue and the resilience of the pharyngeal wall decreased from the soft palatal level to the epiglottic level in these two groups. Only the value of correlation coefficient in the soft palatal level was statistically significant in patients with OSAHS.@*CONCLUSION@#The study suggested that the resilience of pharyngeal wall could be quantitated by applying with multiple detector-row spiral CT. The resilience of oral pharyngeal and its correlation with thickness of retropharyngeal soft tissue may be the highest in soft palatal level.

The latest study and development of cartilage tissue engineering / 生物医学工程学杂志

In this paper are reviewed the current situation and research progress of cartilage tissue engineering, including seeding cell, three-dimensional cytoskeleton, cell culture system and evaluation of artificial cartilage behavior, animal model, and clinical trial.

Hydrophilicity and adsorptivity of a novel scaffold twice embedded by lecithin and poly-L-lysine to human nasal septum chondrocytes / 中国组织工程研究

BACKGROUND:Chitosan is a kind of natural biomaterial and is characterized by great biocompatibility, progressive degeneration and absorption and excellent mechanical property; however, whether it may become an ideal cytoskeleton in the engineering of cartilage tissue or not should be researched further.OBJECTIVE: To observe the hydrophilicity and adsorptivity to human nasal septum chondrocytes and the effect of its function of a novel scaffold made by [poly (dl-lactide-co-glycolide)] (PLGA)/chitosan nonwoven cloth embedded with lecithin (LEC) and poly-L-lysine (PLYS).DESIGN: Blank control study.SETTING: Department of Otolaryngology-Head and Neck Surgery, Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA.MATERIALS: The experiment was carried out in the Department of Otolaryngology-Head and Neck Surgery, Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA from October 2005 to June 2006. Chitosan nonwoven cloth was provided by Hainan Xinlong Company. The mainly technical parameters were detailed as the follows: degree of deacetylation ≥ 90% and relative molecular weight 2-5 × 105. PLGA/chitosan nonwoven cloth scaffold was made in Department of Otolaryngology-Hean and Neck Surgery, Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA and High Polymer Institute of Sun Yat-sen University. The mainly technical parameters were detailed as the follows: mole ratio between monome lactide and glycolide 75:25, porosity 82%-86%, pore diamater 100-300 μm, shear strength 48 MPa, depth 1.5 mm and completely degenerated duration 14-18 weeks. Human nasal septum chondrocytes were the septal cartilage of nose which was derived from operated patients with deflection of nasal septum under sterile condition.METHODS: PLGA/chitosan nonwoven cloth was sheared into pieces with the size of 1.5 cm × 1.5 cm, dipped in 0.01 volume fraction of LEC anhydrous alcohol and 1 g/L PLYS for 6 hours, dealt with ultraviolet radiation after dehydration for 1hour, dipped in 0.75 volume fraction of ethanol for 24 hours, washed with Hanks solution, and incubated for 24 hours. After operations mentioned above, two kinds of novel scaffolds containing various components were obtained, and they were simple scaffold and scaffold embedded with LEC and PLYS. Cells derived from the third generation of human nasal septum chondrocytes were used to make suspension. In addition, cell suspension was grown on those two scaffolds to determine the degree of hydrophilicity through observing diffused degree of cell suspension. Whether cell suspension of human nasal septum chondrocytes was wafted on scaffolds or not were observed under phase contrast microscope so as to determine adsorptivity between cells and scaffolds; meanwhile, growth of cells and production of matrix were also observed.MAIN OUTCOME MEASURES: ① Hydrophilicity of those two kinds of scaffolds (diffused degree of cell suspension of human nasal septum chondrocytes on scaffold) and adsorptivity to cells (whether cell suspension of human nasal septum chondrocytes was wafted on scaffolds or not); ② growth of cells and production of matrix.RESULTS: ① When simple scaffold was put in cell suspension of human nasal septum chondrocytes, cell suspension showing like balls attached to the surface of scaffold, and then, scattered into space of scaffold gradually. During the period of culture, phase contrast microscope indicated that masses of cells attached to the surface of fiber of scaffold.When the petri dish was shaken, cell groups drifted irregularly. The adherent rate was (21±3.7)%. With the cultured time passing by, matrix was not produced. ② When scaffold embedded with LEC and PLYS was put in cell suspension of human nasal septum chondrocytes, cell suspension scattered into space of scaffold rapidly. The adherent rate was (89±5.6)%, which was higher than that of single scaffold group. This suggested that scaffold showed a strong hydrophilicity.Phase contrast microscope indicated that chondrocytes as the form of monome or community were distributed between scaffold and fiber averagely and attached to the surface of fiber of scaffold. When the petri dish was shaken, cell groups did not drift irregularly, and only a few of cells were scarred at the bottom of petri dish. This suggested that scaffold had a strong adsorptivity to cells. One week after culture, matrix showing like cobweb was produced among fibers of scaffold.With the cultured time passing by, matrix was produced abundantly.CONCLUSION: The novel scaffold of PLGA/chitosan nonwoven cloth embedded with LEC and PLYS is characterized by an excellent hydrophilicity and adsorptivity to human nasal septum chondrocytes; meanwhile, it also can secrete matrix.

Status of patients with allergic rhinitis combined with bronchial asthma in Nanjing and the correlation of clinical characteristics / 中国组织工程研究

BACKGROUND: Both Allergic rhinitis and bronchial asthma are allergic diseases of respiratory tract. They frequently coexist in the same patients.OBJECTIVE: To study the incidence of allergic rhinitis in patients with bronchial asthma in Nanjing, and to analyze the correlation of clinical characteristic between allergic rhinitis and bronchial asthma.DESIGN: The questionnaire survey.SETTING: Department of Otorhinolaryngology-Head and Neck Surgery and Department of Respiratory, Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA.PARTICIPANTS: A total of 134 patients with bronchial asthma including 73 males and 61 females were selected form Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA from February 2001 to April 2005. Their ages ranged from 3 to 72 years. Severity of asthma of all patients was classified based on Global Initiative for Asthma (GINA). The diagnostic criteria of allergic rhinitis were established referred to the guideline of Haikou Meeting (November, 1997). All patients provided the confirmed consent.METHODS: The questionnaire survey of 134 bronchial asthma patients from the city of Nanjing was conducted. Their age, classification, severity, treatment status, and the family history of all 134 patients were investigated in details. Differences of age, age at onset, and course of disease between rhinitis and asthma of all patients were examined by two independent t tests. The correlation between clinical characteristics of allergic rhinitis and bronchial asthma was analyzed by Spearman rank correlation.MAIN OUTCOME MEASURES : Incidence of allergic rhinitis in patients with bronchial asthma and the correlation of clinical characteristic between allergic rhinitis and bronchial asthma.RESULTS：Of all 134 bronchial asthma patients，82(61．2％,82/134)were accompanied with allergic rhinitis．There were 45 males and 37 females．Of 82 patients with allergic rhinitis accompanying with bronchial asthma，severity was classified into grade Ⅰ (mild pause,n=56)，grade Ⅱ (mild persistence，n=21)，grade Ⅲ (moderate persistence，n=4)，and grade Ⅳ (severe persistence，n=1)．In addition,allergic rhinitis was classified into periodicity (n=65) and persistence(n=17)．According to the classification and seventy system recommended in ARIA,63 patients had mild symptoms and 19 had moderate and severe symptoms．Severity of allergic rhinitis was positively related to that of bronchial asthma(r=0.689,P＜0．01)．CONCLUSION: The morbidity of allergic rhinitis combining with bronchial asthma is high in Nanjing, China. While, their classification and severity are highly coherent.

The questionnaire survey of children allergic rhini-tis in Nanjing / 中国耳鼻咽喉头颈外科

0.05). Ac-cording to the classification criteria of ARIA in 2001, 26 children suffered from intermittent A(R22 mild cases,4 moderate-severe cases),while 22 suf-fered from persistent AR(10 mild cases,12 mod-erate-severe cases). Forty percent patients with AR also had bronchial asthma. Domestic decora-tion was an important factor in the induction of AR and 27.1% of the children with AR had inher-ent predisposition. CONCLUSION The prevalence rate of AR in children aged from 9 to 10 in Nanjing is 5.1 %. Strategy of prevention and treatment of AR should beworked out according to the epidemic feature of AR.

Pathological changes of maxillary sinus mucosa of rabbits with acute sinusitis / 中国耳鼻咽喉头颈外科

OBJECTIVE To observe the ultra-structure and mucociliary transport speed of maxillary sinus mucosa of experimental rhinogenic acute sinusitis in rabbits.METHODS Fifteen healthy adult male New Zealand white rabbits were divided into experimental group(10 rabbits) and blank control group(5 rabbits) randomly.For the experimental group,a piece of polyvinyl acetal absorbent sponge(Merocel?) in size of 3 mm?5 mm?25 mm was inserted into the right-side nasal cavity of each rabbit.The sponges were soaked with 1ml type Ⅲ streptococcus pneumoniae solution.Two weeks after insertion,the mucociliary transport speed was measured by India ink solution method.All rabbits were sacrificed to obtain the right-side maxillary sinus mucosa for ultrastructure observation through transmission electron microscope.RESULTS The mucociliary transport speed of experimental group was much lower than that of blank control group,and the difference was statistically significant(P

Treatment of moderate or severe obstructive sleep apnea hypopnea syndrome with modified uvulopalatopharyngoplasty and temperature-controlled radiofrequency ablation / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the therapeutic effect of modified uvulopalatopharyngoplasty(UPPP) combined with temperature-controlled radiofrequency ablation(TCRFA) in the treatment of moderate and severe obstructive sleep apnea hypopnea syndrome(OSAHS) . METHODS A total of 83 patients with moderate or severe OSAHS were underwent modified UPPPcombined with TCRFA. All patients were followed-up more than 2 years. Polysomnography was examined at 6 months,1 year and 2 years after operation. RESULTS The curative rate,obvious effective rate and effective rate were 28.9 %,33.7 % and 20.5 % respectively with a total effective rate of 83.1 % at 2 years after operation. The PSG showed that,the AHI values decreased signifi cantly(P

The detection of nitric oxide in nasal chronic inflammation and polyposis / 中国耳鼻咽喉头颈外科

0.05); The concentrations of NO in nasal polyp tissues was higher than that of the nasal mucosa in control group(P

Sampledrawing from animal models of allergic airway inflammation / 医学研究生学报

Objective: Sampledrawing is an important procedure in the study of allergic airway inflammation.The authors investigate the methods of drawing samples from the animals with allergic airway inflammation.Methods: We included in this study 20 Guinea pigs,10 rats and 20 mice,which underwent trachea incision,followed by bronchoalveolar and rhinal lavage and collection of the lavage fluids.Then we collected blood samples via the heart from the guinea pigs and rats and via both the heart and the eyes from the mice,and obtained the tissues of the nasal cavities and lungs by different methods.Results: All the samples were satisfactorily obtained from the animals,and 80% of the bronchoalveolar and rhinal lavage fluids were collected.Conclusion: Different methods should be adopted to suit different sampledrawing from the animal models of allergic airway inflammation.

Correlation of chronic sinusitis and nasal polyposis with lower airway inflammatory diseases / 医学研究生学报

0.05). Conclusion: Although the mechanism of the correlation between upper and lower airway inflammatory diseases is not yet clear,chronic sinusitis and nasal polyposis may share some characteristics in involving the lower airway.

Development of the animal experiment in cartilage tissue engineering and its clinical application / 医学研究生学报

At present,the animal experiment in cartilage tissue engineering has entered the stage of maturely immune mammal,and has been applied to clinical practice rudimentarily with good prospects,as well as with many difficulties.Although still mainly in the phase of animal experiments,cartilage tissue engineering provided a new means of cartilage defect repairing,maybe the chief direction of research in this domain.This study reviews the current situation and research development of the animal experiment in cartilage tissue engineering and its clinical applications.

Endoscopic anatomy of tristar of grooves / 解放军医学杂志

Objective To explore the features of ostiomeatal complex under endoscopic observation,so as to provide reliable landmarks for a safe and perfect endoscopic sinus surgery.Methods Twelve heads from adult cadavers(8 males and 4 females) were split axially on midline with the nasal septum removed,and nasal endoscopic operation was performed for the observation of tristar of groove with professional surgical instruments on anterior ethmoid,frontal sinus and maxillory sinus.Results The tristar of groove was consisted of beak of the ethmoidal bulla and its prolonging process,apex of the uncinate process and anterior peak of the middle turbinate,at the region of frontal recess.The structures called meatal groove,uncinate groove and bullar groove were observed around the ethmoidal bulla and the tristar of groove located at their origination.Under endoscopic view these structures looked like a triangular clefts,so it was named.The cells of the meatal groove located anteromedially to the tristar,the cells of the uncinate groove were anterolateral and just inferoposterior to the meatal groove,those of the bullar groove superoposteriorly located to the cells of the uncinate groove.The ostia of these cells were constant and did not connect each other,their locations at the tristar of grooves were fixed relatively.Conclusion Tristar of grooves is a key area for endoscopic frontal sinusotomy.Due to the great structural variations,the constant landmarks,which can be seen under sinus endoscope,and the regular pattern of the nasal sinuses distribution are important and can guide the endoscopic sinus surgery.