慢性筛窦炎黏膜超微结构变化

Ultrastructural changes of ethmoid sinus mucosa of patients with chronic ethmoiditis

目的观察慢性筛窦炎(chronicethmoiditis)患者筛窦黏膜的超微结构。方法15例慢性筛窦炎患者和4例单纯鼻中隔偏曲患者在接受鼻内镜手术时钳取筛窦黏膜,通过扫描电镜、透射电镜观察其黏膜表面形态及炎细胞浸润的超微结构改变。结果慢性筛窦炎患者筛窦黏膜可观察到黏液颗粒呈串珠样或团片状附着在残存纤毛上;纤毛稀疏、排列凌乱、缠结;细胞连接分离,细胞间隙增宽;基底细胞受损;肥大细胞、嗜酸性粒细胞颗粒释放,浆细胞粗面内质网扩张等超微结构的改变。结论慢性筛窦炎患者筛窦黏膜超微结构的改变是筛窦炎慢性迁延的病理学基础。

OBJECTIVE To observe the ultrastructure of ethmoid sinus mucosa of patients with chronic ethmoiditis. METHODS The specimens were taken from 15 patients with chronic ethmoiditis and 4 patients without chronic ethmoiditis in functional endoscopic sinus surgery. Scanning electron microscopy and transmission electron microscopy were used to observe the ultrastructural changes of impaired ciliated epithelium and inflammation cells. RESULTS Mucus adhered to the remaining cilia in the form of drops and masses. The remaining cilia were discrete or matted together. The specialized contacts between the epithelial cells were absent. The interspace between the epithelial cells was widening. Basal cells were damaged. Mast cells and eosinophils degranulated. Plasma cells exhibited marked dilation of the rough endoplasmic reticulum. CONCLUSION The results showed ultrastructural changes of ethmoid sinus mucosa were the pathological foundation of the chronic ethmoiditis.