Sreedharan Suja, Kamath Mulki Panduranga, Khadilkar Urmila, Hegde Mahesh Chandra, Kumar Rajeev M, Mudunuri Ravikumar Raju, Tripuraneni Satish Chandra
Department of ENT, Katurba Medical College, Attavar, Manglore, Karnataka, India.
Am J Otolaryngol. 2005 May-Jun;26(3):151-6. doi: 10.1016/j.amjoto.2004.11.008.
The inhalation of nasal snuff (powdered tobacco) is a common addiction in the Indian subcontinent. In the western world, there is a resurgence of interest in nasal snuff because it does have the morbidity associated with smoked tobacco. Very few studies have reported the long-term effects of snuff on nasal mucosa. The objective of the present study was to investigate the effect of long-term use of snuff on the nasal mucosa.
We conducted a retrospective study on 29 snuff users. We investigated the reasons for initiation of this particular form of addiction along with the clinical signs and symptoms of long-term snuff usage. At the time of the study, all patients complained of one or more nasal symptoms. Nasal obstruction and nasal discharge taken together were reported by 62.5% of patients. Gross mucosal edema of the septum and turbinates was the main finding on nasal examination. The absolute eosinophil count and total serum immunoglobulin E were elevated in 62.5% and 66.7% of patients, respectively. On skin prick test, 41% of patients reacted positively to snuff and 25% to tobacco. Histopathologic examination of the turbinates (16 patients) showed squamous metaplasia, capillary proliferation, capillary and venous dilatation, inflammatory cell reaction, subepithelial edema, and fibrosis.
Much has been written about the advantages of nasal snuff over products that deliver tobacco smoke. Our study shows that snuff users, after long-term abuse, develop a form of chronic rhinitis, as a consequence of which they develop blocked and stuffy noses. We conclude that nasal snuff is not a suitable substitute for smoked tobacco because it does not avoid ill health.
吸入鼻烟（烟草粉末）在印度次大陆是一种常见的成瘾行为。在西方世界，人们对鼻烟的兴趣再度兴起，因为它确实存在与吸烟相关的发病率。很少有研究报道鼻烟对鼻黏膜的长期影响。本研究的目的是调查长期使用鼻烟对鼻黏膜的影响。
我们对29名鼻烟使用者进行了一项回顾性研究。我们调查了开始这种特殊成瘾形式的原因以及长期使用鼻烟的临床体征和症状。在研究时，所有患者都抱怨有一个或多个鼻部症状。62.5%的患者报告有鼻塞和流涕症状。鼻中隔和鼻甲的明显黏膜水肿是鼻检查的主要发现。62.5%和66.7%的患者绝对嗜酸性粒细胞计数和总血清免疫球蛋白E分别升高。在皮肤点刺试验中，41%的患者对鼻烟呈阳性反应，25%的患者对烟草呈阳性反应。对鼻甲进行组织病理学检查（16例患者）显示有鳞状化生、毛细血管增生、毛细血管和静脉扩张、炎症细胞反应、上皮下水肿和纤维化。
关于鼻烟相对于产生烟草烟雾的产品的优势已有很多论述。我们的研究表明，鼻烟使用者在长期滥用后会发展为一种慢性鼻炎，导致鼻塞和鼻闷。我们得出结论，鼻烟不是吸烟的合适替代品，因为它并不能避免健康问题。
