Histologic evaluation of nasal epithelium of the middle turbinate in untreated OSAS patients and during nCPAP therapy.

OSAS-patients complain about nasal disorders. Irritation of the nasal mucosa often leads to termination of nCPAP treatment. The aim of this study is to evaluate whether symptoms are related to histologic changes of the nasal mucosa of the head of the middle turbinate in OSAS-patients. Semi-thin sections of epon-embedded middle turbinate biopsy samples from 35 male patients (age 51-75 yr) with OSAS were compared with those of 10 healthy men (age 51-75 yr). In untreated OSAS-patients atrophic epithelium is common whereas ciliated epithelial types are rare. After short-time nCPAP therapy (mean 581h) patches of ciliated epithelium and squamous metaplasia reappear. Short-term nCPAP leads to a partially restoration of the mucosal architecture. During long-time nCPAP therapy (mean 6.737h) squamous metaplasia with conspicuous intraepithelial connective tissue papillae predominates whereas pseudostratified ciliated epithelium is missing. Dense round cell infiltrates in the lamina propria are frequently found. Rhinitic symptoms in OSAS-patients are correlated with marked histological changes of the respiratory epithelium of the head of the middle turbinate. Histological changes in untreated OSAS differ from those of patients during nCPAP-treatment.