title: Effect of passive smoking on the ultrastructure of the nasal mucosa in children.
abstract: OBJECTIVE
  Passive exposure to cigarette smoke has been implicated in a number of respiratory childhood disorders. Most studies concerning smoking were directed to its carcinogenic effect on the lungs. However, the effects of smoking on nasal respiratory mucosa have not been widely studied. The aim of the present study was, therefore, to study the ultrastructural changes in the nasal mucosa of a pediatric population exposed to passive smoking.
  
  
  METHODS
  The study included 20 children between the ages of 5 and 11 years, who were scheduled for tonsillectomy and at the same time had a positive history of prolonged exposure to household passive smoke. Another 10 children with a negative household smoking history were included as a control group. All children were nonatopic and with a negative family history of allergy. None of them had adenoids or infective rhinosinusitis.
  
  
  METHODS
  At the time of surgery, a 1-mm(3)  biopsy was taken was taken from the lower border of the inferior turbinate. The specimens were processed and examined with electron microscopy
  
  
  RESULTS
  Examination of the nasal mucosa showed several ultrastructural changes. These included patchy loss of cilia, generalized loss of cilia, squamous metaplasia, hyperplasia of goblet cells and seromucinous acini, and vascular congestion. More severe changes were observed with longer passive exposures to cigarette smoke. The study did not disclose any evidence of ongoing allergic reaction or neoplastic transformations.
  
  
  CONCLUSIONS
  Children exposed to passive cigarette smoke may develop several structural changes in the respiratory nasal mucosa with subsequent negative effects on its ciliary activity and mucociliary function. As a result of these effects, defense mechanisms of the nose may be ruined or lost, and those children may develop persistent sinonasal infections. Exposure of these children to passive smoking for longer periods of time may also induce other significant changes that were not detected in the present study.
authors.affiliation: Department of Otolaryngology, Alexandria Medical School, Alexandria, Egypt. samyelwany@msn.com
authors.forename: Samy
authors.initials: S
authors.lastname: Elwany
authors.forename: Ahmed Aly
authors.initials: AA
authors.lastname: Ibrahim
authors.forename: Zeyad
authors.initials: Z
authors.lastname: Mandour
authors.forename: Iman
authors.initials: I
authors.lastname: Talaat
mesh_terms: D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D020397:Goblet Cells / Q000648:ultrastructure; D006801:Humans; D046529:Microscopy, Electron, Transmission; D009297:Nasal Mucosa / Q000648:ultrastructure*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution