Monell Chemmical Senses Center, Philadelphia, Pennsylvania 19104-3308, USA.
Am J Rhinol Allergy. 2010 Mar-Apr;24(2):110-20. doi: 10.2500/ajra.2010.24.3435.
Chronic rhinosinusitis (CRS) is a complex heterogeneous inflammatory disease that affects the nasal cavity, but the pathological examination of the olfactory mucosa (OM) in this disease has been limited.
Nasal biopsy specimens were obtained from 20 control subjects and 50 CRS patients in conjunction with clinical assessments. Histopathology of these nasal biopsy specimens was performed and immunohistochemistry was used to characterize nonneuronal, neuronal, and inflammatory cells in the OM. These OM characteristics were then evaluated to determine the degree to which pathological features may be related to smell loss in CRS.
Histopathological examination of control and CRS OM revealed changes in the normal pseudostratified olfactory epithelium (OE): intermixing of goblet cells, metaplasia to squamous-like cells, and erosion of the OE. Lower percentages of normal epithelium and olfactory sensory neurons were found in CRS OE compared with controls. Relative to other CRS patients, those with anosmia had the greatest amount of OE erosion, the highest density of eosinophils infiltrating the OE, and exhibited the most extensive abnormalities on CT and endoscopic examination, including being significantly more likely to exhibit nasal polyposis.
Our results suggest that OM pathology observed in nasal biopsy specimens can assist in understanding the degree of epithelial change and sensorineural damage in CRS and the potential for olfactory loss.
慢性鼻-鼻窦炎（CRS）是一种复杂的异质性炎症性疾病，影响鼻腔，但对该病嗅黏膜（OM）的病理检查一直有限。
结合临床评估，从 20 名对照受试者和 50 名 CRS 患者中获得鼻活检标本。对这些鼻活检标本进行组织病理学检查，并使用免疫组织化学来表征 OM 中的非神经元、神经元和炎症细胞。然后评估这些 OM 特征，以确定病理特征与 CRS 嗅觉丧失的关系程度。
对对照和 CRS OM 的组织病理学检查显示正常假复层嗅上皮（OE）的变化：杯状细胞混合、化生为鳞状样细胞以及 OE 侵蚀。与对照组相比，CRS OE 中正常上皮和嗅觉感觉神经元的比例较低。与其他 CRS 患者相比，无嗅觉患者的 OE 侵蚀最严重，嗜酸性粒细胞浸润 OE 的密度最高，并且 CT 和内镜检查显示出最广泛的异常，包括更有可能表现出鼻息肉。
我们的结果表明，鼻活检标本中观察到的 OM 病理学可以帮助了解 CRS 中上皮变化和感觉神经损伤的程度以及嗅觉丧失的潜力。
