Ultrastructural regenerating features of nasal mucosa following microdebrider-assisted turbinoplasty are related to clinical recovery
Autor: | Roberta Di Pietro, Fiorella Cazzato, Maria Antonietta Centurione, Valentina Mastronardi, Lucia Centurione, Mara Pugliese, Giampiero Neri |
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Jazyk: | angličtina |
Předmět: |
Adult
Male Pathology medicine.medical_specialty Adolescent Turbinoplasty Visual analogue scale Nasal Surgical Procedures Microdebrider Mucous membrane of nose Stem cells Turbinates General Biochemistry Genetics and Molecular Biology Muscle hypertrophy Young Adult 03 medical and health sciences Basal (phylogenetics) 0302 clinical medicine Fibrosis Edema Preoperative Care Biopsy Electron microscopy medicine Humans Regeneration 030223 otorhinolaryngology Aged Rhinitis Postoperative Care Medicine(all) medicine.diagnostic_test business.industry Biochemistry Genetics and Molecular Biology(all) Research General Medicine Middle Aged Nasal mucosa medicine.disease Surgery 030220 oncology & carcinogenesis Female Rhinomanometry medicine.symptom business |
Zdroj: | Journal of Translational Medicine |
ISSN: | 1479-5876 |
DOI: | 10.1186/s12967-016-0931-8 |
Popis: | Background 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. Methods 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. Results 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. Conclusions 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. |
Databáze: | OpenAIRE |
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