Wang N, Cheng J, Sheng R, He F, Zhang M, Pan Z, Zhang X, Wang S
Department of Otorhinolaryngology, China-Japan Friendship Hospital, Beijing 100029, China.
Zhonghua Er Bi Yan Hou Ke Za Zhi. 2001 Feb;36(1):38-41.
To observe the ultrastructural changes of olfactory epithelium (OE) in patients suffering from dysosmia caused by chronic sinusitis.
The specimens of olfactory epithelium were obtained from 35 patients operated for chronic sinusitis accompanied by dysosmia. According to the results of light microscope (LM) examination, the OE was divided into three groups by the types of pathological changes: normal, atrophic and respiratory epithelium metaplasia(REM). Transmission electron microscope was used to observe the ultrastructural changes of each group.
Under the LM, the surface ultrastructure of the OE showed some abnormal changes: (1) surface microvillus of the supporting cells disappeared; (2) olfactory vesicle changed their shape due to vacuolization; (3) disappearance of canaliculus structure in the olfactory vesicle; (4) the olfactory cilia changed the shape or reduced; some of the reduced cilia underwent metaplasia. The ultrastructural changes of atrophic OE included: (1) minor and moderate atrophy: the organelles and the membrane-limited electron dense vesicles on the upper section of the supporting cells obviously decreased or disappeared, even underwent vacuolization. The basic cell degenerated; (2) serious atrophy: the turbidity of the cell structure, even double cell structure, the nuclei of the cell aggregated as the plaque and vesiculose change or karyopyknosis. As for the cytoplasm, there were the dilation of the ERs, turgidity of the mitochondrion, the disarrangement, diminution and vacuolization. Fasciculate cilia were distributed separately in the REM group.
There is a positive relationship between the atrophy degree and the degree of the abnormal ultrastructural changes of the OE. The ultrastructural changes of OE in patients suffering from dysosmia caused by chronic sinusitis may provide reference for assessment of the treatment of dysosmia.
观察慢性鼻窦炎所致嗅觉障碍患者嗅上皮（OE）的超微结构变化。
选取35例因慢性鼻窦炎伴嗅觉障碍而接受手术的患者的嗅上皮标本。根据光镜（LM）检查结果，按病理变化类型将OE分为三组：正常组、萎缩组和呼吸上皮化生（REM）组。采用透射电子显微镜观察每组的超微结构变化。
在光镜下，OE的表面超微结构出现一些异常变化：（1）支持细胞的表面微绒毛消失；（2）嗅泡因空泡化而改变形状；（3）嗅泡中的小管结构消失；（4）嗅纤毛改变形状或减少；部分减少的纤毛发生化生。萎缩性OE的超微结构变化包括：（1）轻度和中度萎缩：支持细胞上部的细胞器和膜性电子致密小泡明显减少或消失，甚至发生空泡化。基底细胞退变；（2）重度萎缩：细胞结构浑浊，甚至出现双细胞结构，细胞核聚集呈斑块状及小泡状改变或核固缩。至于细胞质，有内质网扩张、线粒体肿胀、排列紊乱、减少及空泡化。REM组可见束状纤毛散在分布。
OE的萎缩程度与超微结构异常变化程度呈正相关。慢性鼻窦炎所致嗅觉障碍患者OE的超微结构变化可为嗅觉障碍的治疗评估提供参考。
