Nasal and Tracheal Cytological Changes After Total Laryngectomy in Long-Term Survivors.
OBJECTIVE
Complete separation of upper and lower respiratory tract after total laryngectomy results in permanent effects on nasal cavities and tracheo-bronchial airways. Aim of this study is evaluating nasal and tracheal cytological alterations of mucosa in laryngectomy long-term survivors, analyzing the feasibility of scraping for cytological examination of tracheal mucosa.


METHODS
Twenty-five laryngectomy patients underwent symptoms' evaluation, endoscopic fiber optic examination, prick tests, and nasal and tracheal scraping for cytological exam. Twenty-five healthy subjects underwent the same assessment, except for tracheal scraping. Eleven laryngectomy patients accepted inferior turbinate biopsy for histological examination.


RESULTS
Nasal cytological analysis demonstrated mucous cell metaplasia in 20% of laryngectomized patients, but it was absent in all healthy subjects; no squamous cell metaplasia was found in both groups. In 15 patients (60%), bacteria were present, without inflammatory infiltrate. Tracheal cytological analysis demonstrated a quite high rate of squamous cell metaplasia (24%), neutrophilic infiltrate (32%), and presence of bacteria (40%). Histological examination of inferior turbinate showed submucosal stromal fibrosis in all patients and submucosal inflammatory infiltrate in 1 case (9%).


CONCLUSIONS
Nasal cavities and trachea of laryngectomy patients undergo long-term cytological and histological changes of mucosa and submucosa, probably due to airflow modifications.
1 1st ENT Division, Surgical Sciences Department, University of Turin, Turin, Italy.
Giuseppe
G
Riva
2 Allergology and Clinical Immunology, Medical Science Department, University of Turin, Turin, Italy.
Monica
M
Boita
1 1st ENT Division, Surgical Sciences Department, University of Turin, Turin, Italy.
Andrea
A
Corvino
1 1st ENT Division, Surgical Sciences Department, University of Turin, Turin, Italy.
Matteo
M
Sensini
1 1st ENT Division, Surgical Sciences Department, University of Turin, Turin, Italy.
Daniela
D
Peruzzetto
3 Department of Biomedical Sciences and Human Oncology, University of Turin, Turin, Italy.
Luigi
L
Chiusa
1 1st ENT Division, Surgical Sciences Department, University of Turin, Turin, Italy.
Giancarlo
G
Pecorari
1 1st ENT Division, Surgical Sciences Department, University of Turin, Turin, Italy.
Massimiliano
M
Garzaro
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D016022:Case-Control Studies; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D020397:Goblet Cells / Q000473:pathology*; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D009297:Nasal Mucosa / Q000473:pathology*; D020545:Respiratory Mucosa / Q000473:pathology; D000077195:Squamous Cell Carcinoma of Head and Neck; D017741:Survivors; D014132:Trachea / Q000473:pathology*
cytological changes; histological changes; laryngectomy; nasal cytology; total laryngectomy; tracheal cytology