Elwany Samy, Al-Medany Ayman Moustafa, Khalifa Hoda Mahmoud, Salam Sedik Abdel, Soliman Ahmed, Abu el-Kheir Osama
Department of Otolaryngology, Alexandria University, Alexandria, Egypt.
Eur Arch Otorhinolaryngol. 2009 Sep;266(9):1417-22. doi: 10.1007/s00405-009-0917-8. Epub 2009 Feb 19.
Endoscopic coagulation of the sphenopalatine artery (SPA) is indicated in patients with recurrent or severe posterior epistaxis. The present work aimed at studying the effects of the sphenopalatine artery coagulation on the nasal seromucinous glands. The study was carried out on 30 patients who were scheduled for endoscopic SPA coagulation. All patients signed informed consents that were approved by the Committee of Medical Ethics. Minute punch biopsies were taken from the inferior turbinates, under local anesthesia, just before the procedure as well as 12 weeks and 1 year postoperatively. The biopsies were stained with hematoxylin and eosin and PAS Alcian blue. Histochemical examination was done for the activity of the succinic dehydrogenase, alkaline phosphatase and cholinesterase enzymes. Morphometric analysis as well as analysis of the histological and histochemical results showed that SPA coagulation was followed by an early decrease in the size, number and secretory activity of the nasal seromucinous glands, which was associated with decreased activity of the alkaline phosphatase enzyme in the endothelial cells of the nasal blood vessels and decreased activity of the cholinesterase enzyme in the cholinergic nerve fibers. These changes, however, were temporary and reversible since examination of the late postoperative biopsies, at 1 year, showed normalization of the number, appearance, and histochemical activity of the glandular acini as well as the surrounding blood vessels and cholinergic nerve fibers.
蝶腭动脉（SPA）内镜下凝固术适用于复发性或严重的鼻后段鼻出血患者。本研究旨在探讨蝶腭动脉凝固术对鼻浆液性腺的影响。该研究对30例计划接受内镜下SPA凝固术的患者进行。所有患者均签署了经医学伦理委员会批准的知情同意书。在局部麻醉下，于手术前、术后12周和1年从下鼻甲取微小组织块活检。活检组织用苏木精-伊红染色及PAS阿尔辛蓝染色。对琥珀酸脱氢酶、碱性磷酸酶和胆碱酯酶的活性进行组织化学检查。形态学分析以及组织学和组织化学结果分析显示，SPA凝固术后鼻浆液性腺的大小、数量和分泌活性早期下降，这与鼻血管内皮细胞中碱性磷酸酶活性降低以及胆碱能神经纤维中胆碱酯酶活性降低有关。然而，这些变化是暂时且可逆的，因为术后1年的晚期活检显示腺泡以及周围血管和胆碱能神经纤维的数量、外观和组织化学活性恢复正常。
