Yilmaz F, Koyuncu M, Coşkun C, Yildiz L, Bernay I, Seşen T
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Ondokuz Mayis University Medical School, Samsun, Turkey.
Rhinology. 2000 Sep;38(3):150-5.
The aims of the study were to investigate the effects of natural ostium and the nasoantral window on the mucosal regeneration after maxillary sinus surgery and to detect the changes in the mucociliary clearance during regeneration process. Twenty-eight rabbits were studied. In the study group consisting of 21 rabbits, the mucosa of each right maxillary sinus was totally removed, natural ostium was occluded with bone-wax and a nasoantral window was created, while the left sinus mucosa was removed and the natural ostium was left open without creating a nasoantral window. Maxillary sinus mucosa taken during surgery was investigated by light and electron microscopy. The study group was divided into three subgroups. The first group was followed for 2, the second for 4, and the last group for 8 weeks. At the end of these periods, the mucociliary function was evaluated scintigraphically using 99mTc-Human serum albumin. Following this investigation mucosal biopsies were taken from the right and left sinuses and the rabbits were sacrificed. In the control group consisting of 7 rabbits a small hole was opened in the anterior wall of the maxillary sinus of each rabbit and the scintigraphic evaluation was performed for this group at the end of each follow up period as well. In the histopathologic investigation, no difference was found between the natural and the nasoantral window using light microscopy, but there was a difference between them in the electron microscopic findings (p < 0.05, Chi-square test). The scintigraphic, light and electron microscopic findings and gross appearances of the sinuses are discussed.
本研究的目的是探讨自然开口和鼻-窦开窗对上颌窦手术后黏膜再生的影响，并检测再生过程中黏液纤毛清除功能的变化。对28只兔子进行了研究。在由21只兔子组成的研究组中，每只兔子右侧上颌窦的黏膜被完全去除，自然开口用骨蜡封闭，并制作一个鼻-窦开窗，而左侧鼻窦黏膜被去除，自然开口保持开放，不制作鼻-窦开窗。对手术中获取的上颌窦黏膜进行光镜和电镜检查。研究组分为三个亚组。第一组随访2周，第二组随访4周，最后一组随访8周。在这些时间段结束时，使用99mTc-人血清白蛋白通过闪烁显像评估黏液纤毛功能。在这项检查之后，从左右鼻窦获取黏膜活检组织，并处死兔子。在由7只兔子组成的对照组中，在每只兔子上颌窦前壁开一个小孔，并且在每个随访期结束时也对该组进行闪烁显像评估。在组织病理学检查中，光镜下自然开口和鼻-窦开窗之间未发现差异，但在电镜检查结果中它们之间存在差异（p<0.05，卡方检验）。讨论了鼻窦的闪烁显像、光镜和电镜检查结果以及大体外观。
