title: Cytologic alterations in nasal mucosa after sphenopalatine artery ligation in patients with vasomotor rhinitis.
abstract: BACKGROUND
  Vasomotor rhinitis (VR) seems to be related to an imbalance between cholinergic and adrenergic activity in the autonomic nervous system. The nerve fibers of the sympathetic and parasympathetic nervous systems reach the nose through the posterior nasal nerve, which,  after crossing the sphenopalatine foramen, distributes to the mucosa following the branches of the sphenopalatine vessels. This study was designed to evaluate the effect of sphenopalatine artery ligation on nasal function and nasal cytology in patients with VR.
  
  
  METHODS
  Thirty  patients with VR and bilateral inferior turbinate hypertrophy (ITH) were randomly assigned to receive endoscopic inferior turbinoplasty either with or without sphenopalatine artery ligation. Pre- (baseline) and postsurgical (1-year follow-up) assessment included fiber endoscopy, active anterior  rhinomanometry, measurement of mucociliary transport time (MTt), and nasal cytology examination.
  
  
  RESULTS
  At 1-year follow-up there was a statistically significant improvement in nasal resistances in both groups but not on intergroup comparison; MTt significantly decreased  in both groups (p < 0.01) and was significantly better (p < 0.05) in the group that had undergone sphenopalatine artery ligation. Among the patients in this group, significantly fewer were found to have altered ciliated cells (p < 0.005) or a hyperchromatic supranuclear stria (p <  0.005) on nasal cytology; the differences were statistically significant also on intergroup comparison (p < 0.005 and p < 0.001, respectively).
  
  
  CONCLUSIONS
  In patients with vasomotor rhinopathy and ITH, improvement in symptoms, nasal resistance, ciliated cell trophism,  and MTt was observed after sphenopalatine artery ligation.
authors.affiliation: Department of Otorhinolaryngology, University of Foggia, Via Guerrieri 2, Foggia, Italy. m.cassano@unifg.it
authors.forename: Michele
authors.initials: M
authors.lastname: Cassano
authors.forename: Luigi
authors.initials: L
authors.lastname: Russo
authors.forename: Alessandro Maselli
authors.initials: AM
authors.lastname: Del Giudice
authors.forename: Matteo
authors.initials: M
authors.lastname: Gelardi
mesh_terms: D000328:Adult; D001158:Arteries / Q000473:pathology / Q000601:surgery*; D001338:Autonomic Fibers, Postganglionic / Q000473:pathology / Q000601:surgery*; D002923:Cilia / Q000473:pathology; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D009079:Mucociliary Clearance; D009297:Nasal Mucosa / Q000098:blood supply / Q000294:innervation / Q000473:pathology* / Q000601:surgery; D015508:Nasal Obstruction / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D012223:Rhinitis, Vasomotor / Q000150:complications / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult