[Pathological and ultrastructural observation on the epithelia of nasal cavity and nasal sinuses in chronic sinusitis and nasal polyps after endoscopic sinus surgery].
OBJECTIVE
To research the restoration characteristics of epithelia in nasal cavity and nasal sinuses with chronic sinusitis and nasal polyps after endoscopic sinus surgery,and to provide basis for improving the treatment after operation.


METHODS
Twenty patients with chronic sinusitis and nasal polyps after endoscopic sinus surgery were observed. The "Vesicle tissues" situated ostiomeatal complex (OMC) were observed with light and transmission electron microscopy after operation of 7-14 days.


RESULTS
(1) The "Vesicle tissues" were off white or buff, some contained liquid, and some were parenchyma under the endoscopy. (2) The epithelia of "Vesicle tissues" were pseudostratified ciliated columnar epithelium (16/20), and some were stratified squamous epithelium (2/20), some were squamous metaplasia in pseudostratified ciliated columnar epithelium (2/20). Lamina propria were edema. Inflammation cells infiltrated epithelial lining and subepithelial lining. We found mucous gland, mixed gland and glandular duct under subepithelial lining,and small vascular ectasia under light microscopy. (3) Transmission electron microscope: epithelia were pseudostratified ciliated columnar epithelium, cilia were in good order, microvilli located between cilia. The cross section of majority cilia were 9 + 2 form microtubule, but in some cilia we could not find microtubule and could only find one central microtubule. Golgi complex were up growth, and endoplasmic reticulum expand, and multi-mitochondrion were coagulation degeneration in epithelial cells. Some mitochondrion were 1-2 degree swelling and the lysosome increased. Inflammation cells infiltrated epithelial lining. Majority were neutrophil and lymphocyte, but we also found eosinophil and plasmacyte.


CONCLUSIONS
"Vesicle tissues" is the manifestation of active epithelia regeneration in nasal cavity and nasal sinuses after endoscopic sinus surgery, it's the earlier period of imbalance regeneration of the epithelization in postoperative cavity. "Vesicle tissues" is similar to the nasal polyp histopathology, and it is phenomena of limited pathological rebuilding in earlier period. Cleaning "Vesicle tissues" can effectively control the nasal polyps relapse and impel the postoperative cavity to epithelization.
Liu
Lizhong
L
Department of Otorhinolaryngology, West China Hospital, Sichuan University, Chengdu, 610041, China. liulizhongno.1@163.com
Liang
Chuanyu
C
D000328:Adult; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D009296:Nasal Cavity / Q000473:pathology / Q000648:ultrastructure*; D009298:Nasal Polyps / Q000473:pathology* / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D010256:Paranasal Sinuses / Q000473:pathology / Q000648:ultrastructure*; D012852:Sinusitis / Q000473:pathology* / Q000601:surgery