Ultrastructural regenerating features of nasal mucosa following microdebrider-assisted turbinoplasty are related to clinical recoveryReport as inadecuate




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Journal of Translational Medicine

, 14:164

Clinical translation

Abstract

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.

MethodsA 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.

ResultsVideoendoscopy 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.

ConclusionsThe 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.

KeywordsNasal mucosa Rhinitis Turbinoplasty Microdebrider Stem cells Electron microscopy  Download fulltext PDF



Author: Giampiero Neri - Fiorella Cazzato - Valentina Mastronardi - Mara Pugliese - Maria Antonietta Centurione - Roberta Di Pietro

Source: https://link.springer.com/







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