Haruna Shinichi, Otori Nobuyoshi, Moriyama Hiroshi, Nakanishi Marcio
Department of Otolaryngology, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo 105, Japan.
Auris Nasus Larynx. 2006 Mar;33(1):23-30. doi: 10.1016/j.anl.2005.09.005. Epub 2005 Nov 15.
To compare the number of activated eosinophils in the ethmoidal sinus mucosa with the computed tomographic findings and degree of olfactory dysfunction, and study the clinical characteristics of this disease.
Ethmoidal sinus mucosal specimens were obtained from 84 patients with bilateral sinusitis accompanied by endoscopic sinus surgery (ESS). The percentage of activated eosinophils identified by staining with EG2 antibody was compared with the nasal symptoms (nasal obstruction, nasal discharge, headache, problems of smell and overall), the CT images and the olfactory dysfunction assessed using the T&T olfactometry kit and the Alinamin test. In addition, comparison was made of the endoscopic findings obtained after the ESS and the results of the T&T olfactometry assessment.
Specimens from 42 patients were classified in the group showing a high percentage of EG2-positive cells, while specimens from 40 patients were classified in the group showing a low percentage of EG2-positive cells. Comparison of the subjective symptoms in these two groups found a statistically significant difference only in relation to "problems of smell", while comparison of the two groups in terms of the CT scan findings found significant differences only in relation to the anterior and posterior ethmoidal sinuses. In addition, it was found that there was a possibility of manifestation of olfactory dysfunction in the group with a high percentage of EG2-positive cells even when the overall CT score was low. Comparison of the postoperative ethmoidal sinus endoscopic findings and the results using the T&T Olfactometry kit revealed that olfactory dysfunction occurs together with aggravation of the lesions.
For the diagnosis of sinusitis accompanied by severe infiltration of activated eosinophils, attention should be paid not only to the eosinophil counts in the blood and the tissues, but also to the clinical findings, such as the status of lesions in the ethmoidal sinus as seen in CT scans and the manifestation of olfactory dysfunction.
比较筛窦黏膜中活化嗜酸性粒细胞数量与计算机断层扫描结果及嗅觉功能障碍程度，并研究该疾病的临床特征。
从84例双侧鼻窦炎并接受鼻内镜鼻窦手术（ESS）的患者中获取筛窦黏膜标本。将用EG2抗体染色鉴定的活化嗜酸性粒细胞百分比与鼻部症状（鼻塞、流涕、头痛、嗅觉问题及总体症状）、CT图像以及使用T&T嗅觉检测试剂盒和阿林明试验评估的嗅觉功能障碍进行比较。此外，还对ESS术后的鼻内镜检查结果与T&T嗅觉检测评估结果进行了比较。
42例患者的标本被归类为EG2阳性细胞百分比高的组，40例患者的标本被归类为EG2阳性细胞百分比低的组。两组主观症状比较发现，仅在“嗅觉问题”方面存在统计学显著差异，而两组CT扫描结果比较发现，仅在筛窦前后组方面存在显著差异。此外，还发现即使总体CT评分较低，EG2阳性细胞百分比高的组也有可能出现嗅觉功能障碍。术后筛窦鼻内镜检查结果与使用T&T嗅觉检测试剂盒的结果比较显示，嗅觉功能障碍与病变加重同时出现。
对于伴有活化嗜酸性粒细胞严重浸润的鼻窦炎诊断，不仅应关注血液和组织中的嗜酸性粒细胞计数，还应关注临床检查结果，如CT扫描所见筛窦病变情况及嗅觉功能障碍的表现。
