Ultrastructural regenerating features of nasal mucosa following microdebrider-assisted turbinoplasty are related to clinical recovery.
The nasal mucosa plays a key role in conditioning the inhaled air and in regulating the immune response. These functions led many authors to recommend mucosal sparing techniques for the surgical management of inferior turbinate hypertrophy. However, the histological modifications of chronic diseases retain the inflammatory activity and prevent the nasal physiology restoration. It has been proved that the basal cells of the nasal mucosa are able to proliferate and to repair after cold-knife incision. The aim of this study was to demonstrate that the healing process after removal of the inferior turbinate mucosa with cold techniques results in a complete structural restoration.



A prospective study was performed in 18 patients who underwent Microdebrider inferior turbinoplasty (cold technique). Subjective and objective improvement of nasal patency was evaluated with visual analogue scale, rhinomanometry, videoendoscopy and mucociliary transport test. Pre- and post-operative biopsy specimens were taken from 7 patients to evaluate the healing process. Two samples were taken from two healthy patients as control. The specimens were processed for transmission electron microscopy analysis.



Videoendoscopy showed reduction of lower turbinate after surgery. Nasal patency augmented and no adverse consequences were observed. After 4 months the nasal mucosa showed normal appearance, with restoration of the pseudostratified ciliated pattern, intercellular connections and normal cellular morphology. Fibrosis and submucosal edema disappeared. At longer time after operation (4 years) clinical improvement was confirmed.



The total removal of the nasal mucosa with cold techniques results in a complete restoration of the normal structure and permanent resolution of the chronic inflammation typical of hypertrophic rhinopathy.
Department of Neuroscience and Imaging, Faculty of Medicine, University "G. d'Annunzio", Chieti-Pescara, Italy.
Giampiero
G
Neri
Department of Neuroscience and Imaging, Faculty of Medicine, University "G. d'Annunzio", Chieti-Pescara, Italy.
Fiorella
F
Cazzato
Department of Neuroscience and Imaging, Faculty of Medicine, University "G. d'Annunzio", Chieti-Pescara, Italy.
Valentina
V
Mastronardi
Department of Neuroscience and Imaging, Faculty of Medicine, University "G. d'Annunzio", Chieti-Pescara, Italy.
Mara
M
Pugliese
Institute of Molecular Genetics, National Research Council, Pavia, Section of Chieti, Italy.
Maria Antonietta
MA
Centurione
Department of Medicine and Aging Sciences, Section of Human Morphology, University "G. d'Annunzio", Chieti-Pescara, Italy.
Roberta
R
Di Pietro
Department of Medicine and Aging Sciences, Section of Human Morphology, University "G. d'Annunzio", Chieti-Pescara, Italy. lucia.centurione@unich.it.
Lucia
L
Centurione
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000601:surgery / Q000648:ultrastructure*; D059747:Nasal Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D011182:Postoperative Care; D011300:Preoperative Care; D012038:Regeneration; D014420:Turbinates / Q000601:surgery*; D055815:Young Adult
Electron microscopy; Microdebrider; Nasal mucosa; Rhinitis; Stem cells; Turbinoplasty