Long-term histopathological changes of the nasal mucosa after total laryngectomy: a prospective cohort study.

Autor:	Tomoum MO; Department of Otorhinolaryngology, Faculty of Medicine, University of Tanta, Tanta, Egypt., Abdelaziz MF; Department of Otorhinolaryngology, Faculty of Medicine, University of Tanta, Tanta, Egypt., Younes A; Department of Otorhinolaryngology, Faculty of Medicine, University of Tanta, Tanta, Egypt., El-Afandi H; Department of Otorhinolaryngology, Faculty of Medicine, University of Tanta, Tanta, Egypt., Sheta M; Department of Otorhinolaryngology, El-Mahalla general hospital, Tanta, Egypt., Elkelany MM; Department of Histology, Faculty of Medicine, University of Tanta, Tanta, Egypt., El-Naggar A; Department of Otorhinolaryngology, Faculty of Medicine, University of Tanta, Tanta, Egypt.
Jazyk:	angličtina
Zdroj:	Rhinology [Rhinology] 2022 Apr 01; Vol. 60 (2), pp. 118-127.
DOI:	10.4193/Rhin21.284
Abstrakt:	Background: Changes in the nasal function following total laryngectomy resulted in histopathological alterations of the nasal mucosa. We aimed to evaluate the long-term histopathological changes and the mucociliary clearance (MCC) of the nasal mucosa after total laryngectomy. Methods: We performed a histological examination of inferior turbinate biopsy, and saccharine test to assess the MCC time for patients who were candidates for total laryngectomy before the procedure, 6-12 months after surgery, and at least two years postoperatively. Results: Seventy-five patients scheduled for total laryngectomy were initially enrolled in our study. We excluded patients who received postoperative radiotherapy or were lost during the follow-up period. Eventually, 63 and 54 patients were available for assessment 6-12 months after surgery and at least two years postoperatively, respectively. Except for ciliary and goblet cell destruction, which were significantly reduced 6-12 months postoperatively, there were no statistically significant differences in the histopathological findings of the nasal mucosa before surgery and 6-12 months postoperatively. After two years, the histopathological alterations of the nasal mucosa were statistically more evident than those before surgery and 6-12 months postoperatively; the most common histopathological findings were mononuclear cell infiltration and stromal fibrosis. The mean MCC time preoperatively was 12.56 minutes that statistically significantly decreased to 11.81 minutes 6-12 months after surgery; then, it significantly increased to 20.98 minutes at least two years postoperatively. Conclusions: After total laryngectomy, the nasal mucosa showed histopathological alterations and early enhancement of the MCC, which was later impaired due to nasal mucosal atrophy and the saprophytic infection.
Databáze:	MEDLINE
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