title: Choanal atresia: histochemical, immunohistochemical and ultrastructure study of the nasal mucosa.
abstract: OBJECTIVE
  To study the nasal mucosal changes in cases with choanal atresia at the light and electron microscope and to compare the results with the normal side in unilateral cases.
  
  
  METHODS
  Cross sectional study.
  
  
  METHODS
  Tertiary University hospital, departments of Otolaryngology and pathology.
  
  
  METHODS
  Sixteen patients diagnosed to have choanal atresia (seven bilateral and nine unilateral); ranging in age from 3 days to 9 years; were included in this study. During surgical repair, a biopsy of the inferior turbinate mucosa was taken. Biopsy from patent side in unilateral choanal atresia was also taken (as a control). Then biopsies were subjected to histopathological, histochemical, immunohistochemical and ultrastructure studies.
  
  
  RESULTS
  The nasal mucosa in choanal atresia side (weather unilateral or bilateral) showed distorted cilia, marked increase of mucous submucosal glands associated with marked reduction of goblet cell density and lymphocytic cellular infiltration. The patent side (control) showed normal respiratory epithelium with obviously noted intra-epithelial goblet cells. Submucosal glands were less in number and activity than in the atretic side.
  
  
  CONCLUSIONS
  Choanal atresia showed a condition of the nasal mucous membrane with characteristic excessive nasal tenacious secretion; mostly actively secreted besides some effect of lack of drainage due to interrupted cilia. Further studies are required to evaluate the impact of atresia repair on detected features.
authors.affiliation: Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Egypt.
authors.forename: Ezzeddin
authors.initials: E
authors.lastname: Elsheikh
authors.affiliation: Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Egypt. Electronic address: mwenteg@yahoo.com.
authors.forename: Mohammad Waheed
authors.initials: MW
authors.lastname: El-Anwar
authors.affiliation: Pathology Department, Faculty of Medicine, Zagazig University, Egypt.
authors.forename: Hesham Radwan
authors.initials: HR
authors.lastname: Abdel-aziz
authors.affiliation: Pathology Department, Faculty of Medicine, Zagazig University, Egypt.
authors.forename: Anan Fatehy
authors.initials: AF
authors.lastname: Mohamed
authors.affiliation: Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Egypt.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Annany
mesh_terms: D001706:Biopsy; D002452:Cell Count; D002648:Child; D002675:Child, Preschool; D002754:Choanal Atresia / Q000473:pathology* / Q000601:surgery; D002923:Cilia / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D020397:Goblet Cells / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008854:Microscopy, Electron; D009297:Nasal Mucosa / Q000473:pathology*
keywords: Choanal atresia; Electron microscope; Nasal mucosa