Melatonin deficiency at tissue level: a possible aetiological factor in nasal polyposis.

OBJECTIVE: The aim of this study was to examine whether melatonin is involved in the pathogenesis of nasal polyposis. METHOD: This study included 29 patients with nasal polyposis and undergoing functional endoscopic sinus surgery. As a control group, 26 patients who had been operated on for a deviated nasal septum and concha bullosa were enrolled. Samples were taken from the nasal polyp tissue and from the resected middle concha bullosa mucosa of the control group. Serum samples were taken from all patients. RESULTS: It was found that the tissue and serum melatonin levels in the nasal polyp group were significantly lower compared with the tissue and serum melatonin levels in the control group. CONCLUSION: In nasal polyposis, the melatonin level in the serum and tissue is lower than in individuals without polyposis. This deficiency may play a role in the pathogenesis of nasal polyposis.

In-depth analysis of pH-dependent mechanisms of electromechanical reshaping of rabbit nasal septal cartilage.

OBJECTIVES/HYPOTHESIS: Electromechanical reshaping (EMR) involves reshaping cartilage by mechanical deformation and delivering electric current to the area around the bend axis, causing local stress relaxation and permanent shape change. The mechanism of EMR is currently unclear, although preliminary studies suggest that voltage and application time are directly related to the concentration and diffusion of acid-base products within the treated tissue with little heat generation. This study aims to characterize local tissue pH changes following EMR and to demonstrate that local tissue pH changes are correlated with tissue damage and shape change. STUDY DESIGN: Ex vivo animal study involving EMR of rabbit nasal septal cartilage and biochemical estimation of tissue pH changes. METHODS: The magnitude and diffusion of acid-base chemical products in control (0V, 2 minutes), shape change (4V, 4 minutes; 6V, 1, 2, 4 minutes; 8V, 1, 2 minutes), and tissue damage (8V, 4, 5 minutes; 10V, 4, 5 minutes) parameters following EMR are approximated by analyzing local pH changes after pH indicator application. RESULTS: There is a direct relationship between total charge transfer and extent of acid-base product diffusion (P <0.05). A "pH transition zone" is seen surrounding the bend apex above 8V, 2 minutes. Colorimetric analysis suggests that small local pH changes (10(-8) hydrogen ions) are at least partly implicated in clinically efficacious EMR. CONCLUSIONS: These results provide additional insight into the translational applications of EMR, particularly the relationship among pH changes, shape change, and tissue injury, and are integral in optimizing this promising technology for clinical use.

[Funtcional and morphological changes in nasal mucosa in patients presenting with septal deformation].

This study was designed to obtain morpho-functional characteristics of nasal mucosa associated with septal deformation. It has demonstrated disturbances in the mucociluary transport, compromised mucosal immunity, and morphological changes in the nasal cavity.

Deleterious effect of smoking and nasal septal deviation on mucociliary clearance and improvement after septoplasty.

OBJECTIVES: To investigate the effect of septal deviation, septoplasty, and smoking upon nasal mucociliary clearance by using saccharine test. METHODS: Included in this study were 40 patients (15 women and 25 men) who had septal deviation and septoplasty surgery performed between March and June 2006. Patients are classified into three groups: group I (n = 20) nonsmoking patients who had septoplasty surgery, group II (n = 20) smoking patients who had septoplasty surgery, and the control (n = 20) group. None of the control group has nasal breathing problem or smoking history. For determining preoperative and postoperative nasal mucociliary clearance (MCC) time, a saccharine test was performed on the patients 1 day before surgery and at the third month of postoperative control. RESULTS: Preoperative and postoperative nasal MCC time in patients of group I are statistically significantly lower than the group II (p < 0.01). Postoperative MCC time in group I and II is significantly decreased compared with preoperative MCC time, statistically (p < 0.01). Preoperative and postoperative MCC time of group I and group II is significantly higher than MCC time of the control group (p < 0.01). CONCLUSION: Nasal septal deviation and smoking deteriorates nasal MCC time and this result can be shown easily with the saccharine test. Properly performed septoplasty surgery decreases nasal MCC time during the late postoperative period but MCC times are still longer than normal. The saccharine test can be used for following up the effect of septoplasty upon nasal mucosa.

Scanning electron microscopy of ciliae and saccharine test for ciliary function in septal deviations.

OBJECTIVE: To investigate the difference in mucociliary clearance and surface mucosal structure of the nasal septum and lateral nasal wall in patients with and without septal deviation. METHOD: The saccharine-dye test was used to measure the mucociliary clearance time in both nasal cavities of 20 patients with nasal septal deviation (study group) and was compared with that of 30 patients without septal deviation (control group). Bilateral septal and lateral nasal wall mucosal biopsies were taken from the study group during septoplasty, and unilateral biopsies were taken from 10 of the control group. These biopsies were studied under the scanning electron microscope. RESULTS: In the study group, mucociliary clearance on the side opposite the septal deviation was significantly slower than on the other side. Mucociliary clearance on both sides of the deviated septum of the study group was significantly slower than clearance in the control group. There was no statistically significant difference in the distribution of mucosal cilia of the cavities on either side of the deviated septum in the study group, nor between the distribution in the study group and controls. CONCLUSION: Patients with septal deviation display no change in mucosal surface anatomy but have decreased mucociliary activity on both sides of the deviation, the least activity being on the side opposite the deviation.