A biofilm exists on healthy mucosa of the paranasal sinuses: a prospectively performed, blinded, scanning electron microscope study.

OBJECTIVES: Based on our hypothesis that biofilm is nothing else but normal, otherwise abundantly colonised mucosal mucous blanket, the aim of this study was to check out whether bacterial biofilm exists exclusively at the diseased mucosal surfaces or at healthy mucosa of paranasal sinuses as well. DESIGN: Prospective and blinded. SETTING: Tertiary academic hospital. PARTICIPANTS: The patients suffering from the diseases not related to the chronic inflammation of the paranasal sinuses. Mucosal tissue samples from healthy sphenoid sinuses were taken from 48 patients who underwent pituitary gland surgery and from ethmoidal sinuses mucosa of the 17 patients who underwent endonasal endoscopic orbital decompression because of Graves' disease. MAIN OUTCOME MEASURES: The samples were submitted blindly along with similar samples from patients with chronic rhinosinusitis to two scanning electron microscope experts. In all samples the looked for the main signs of biofilm presence of: the 'towers', rod-shaped bacteria and water channels. RESULTS: Signs of biofilm presence were found in 45 out of 48 pituitary gland surgery patients (94%) and in all of 17 EEOD patients (100%). CONCLUSIONS: Our study showed the presence of the biofilm at the surface of the healthy mucosa of the paranasal sinuses. This suggests that perhaps so called bacterial biofilm is nothing else but regular respiratory mucosal blanket, a part of the mucociliary system itself, containing a great number of bacteria.

[Ultrastructural observation on the uncinate process of chronic sinusitis].

The ultrastructures of the uncinate processes (UP) obtainel from 16 patients with clinical diagnosis of chronic sinusitis were observed by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The results showed that there were three main surface cell types on the UP: Most of the cilia was leaned, fractured and in disorder; Gaps of the cells increased obviously; Squamous cell metaplasia was seen; The endoplasmic reticulums and mitochondria in cytoplasm were expanded moderatly or seriously. The morphological changes indicated that mucus transportation functions in the anterior ethmoid region and the middle meatus were damaged. It is of great importance in occurrence and development of chronic sinusitis. The demaged nasal mucosa epithlial cells are repairable and reproducible.

[The uncinate process: ultrastructural and CT studies].

To provide further understanding of uncinate process, 15 uncinate processes were examined under scanning electron microscope, and 32 high-resolution coronal CT scans were studied in patients with septal deformity or sinusitis. It was found that(1)pathological ultrastructural changes of uncinate process were noted in patients with chronic sinusitis; (2) medially deviated, laterally deviated, pneumatization and hypertrophy of uncinate process were demonstrated. The following conclutions were drawn(1)the anatomic variations in ostiomeatal complex is responsible for the formation of chronic sinusitis; (2)for patients with chronic sinusitis, uncinatectomy is the treatment of choice; (3)preoperative and intraoperative studies of CT scans are mandatory for avoidance of complications.

The uncinate process: a histological and morphological study.

The uncinate process (UP) has become a familiar anatomical landmark to otolaryngologists due to the increasing popularity of functional endoscopic sinus surgery (FESS) in recent years. This study examines the histological and morphological features of UPs removed from a group of patients undergoing FESS operations for chronic sinusitis. The structure of the UP by light microscopy (LM) is reported. A relatively high proportion of goblet cells and seromucous glands was noted. Scanning electron microscopy (SEM) identified four surface cell types on the UP. Furthermore, four categories of surface morphology were noted. The most common appearance was of predominantly ciliated cells. A nonciliated surface ultrastructure is associated with a longer history of sinonasal symptoms and a higher incidence of surgical intervention.

Adenocarcinoma of the ethmoid olfactory mucosa: a histopathological and ultrastructural study with evidence of virus-like particles.

A histopathological, morphometric and ultrastructural study was made of enzootic nasal neoplasia in a group of 25 Verata goats. A nasal adenocarcinoma was diagnosed. The neoplasm contained two clearly defined zones, one cystic and the other compact. The tumour stroma was composed of abundant loose connective tissue, in which mononuclear infiltrate was clearly identifiable. The observed viral particles were morphologically similar to Visna-Maedi. These particles had an eccentrically located electrodense core. The diameter of the virus was about 90 nm and it showed envelope numerous spikes on the surface. The virus is assumed to be the causative primary agent of the tumour.

Extra-skeletal Ewing's sarcoma of the nasal fossa.

Extraskeletal Ewing's sarcoma is rarely found arising in the head and neck region. An unusual case arising in the nasal fossa in a young child is reported and the differential diagnosis, pathology and treatment discussed.

Histological and electron microscopic studies of endemic ethmoidal carcinomas in cattle.

In five cases of endemic ethmoidal carcinoma in cattle from the Dominican Republic three tumor types could be classified: undifferentiated carcinoma (3), adenocarcinoma (1), and squamous cell carcinoma (1). Electron microscopy showed that the tumor cells in undifferentiated carcinomas closely resembled the cells of the normal olfactory mucosa. This was especially true for the dark cells of Bowman's gland. Ultrastructurally, the lymphoid cells of the undifferentiated bovine carcinoma resembled the lymphoid cells of human nasopharyngeal carcinoma being closely associated with Epstein-Barr Virus. This and epidemiological observations suggested a viral cause of endemic ethmoidal carcinoma.