Department of Otorhinolaryngology, College of Medicine, Gyeongsang National University, Jinju, Korea.
Am J Rhinol Allergy. 2011 May-Jun;25(3):112-6. doi: 10.2500/ajra.2011.25.3595.
Postoperative treatment after functional endoscopic sinus surgery (FESS) aims to modulate the wound healing process. Systemic or topically applied corticosteroids have been reported to be beneficial for improving nasal wound healing after FESS. However, few studies have investigated the effects of postoperative systemic steroids on nasal wound healing with regard to histological changes. The aim of this study was to evaluate the effect of systemic dexamethasone on nasal wound healing after mechanical injury in the rat.
A unilateral wound in the nasal cavity was induced using the brushing technique in 4-week-old, Sprague-Dawley rats (n = 70). Dexamethasone (0.15 mg/kg daily for 7 days) and normal saline were administered i.p. to the experimental and control groups (n = 35 for each) after the injury. The rats (n = 7 for each) were killed on days 2, 5, 14, 28, and 42 after the injury. Histological changes in the nasal mucosa were examined and compared using hematoxylin and eosin and Masson's trichrome staining.
The experimental group showed less subepithelial edema formation and epithelial disarray at the early phase of the wound healing period. There were statistically significant differences in the subepithelial thickness and epithelial thickness indices between the experimental and control groups (p < 0.05). Ciliary and goblet cell indices were lower in the experimental group, which means that ciliary and goblet cell regeneration may be delayed by dexamethasone (p < 0.05). There were no differences in the subepithelial fibrosis index between the two groups. Adhesion formation between the nasal septum and turbinate were found only in the control group.
Systemic dexamethasone after mucosal injury may lessen subepithelial edema, goblet cell hyperplasia, and adhesion formation; however, it may cause delayed mucosal ciliary regeneration.
功能性内窥镜鼻窦手术(FESS)后的术后治疗旨在调节伤口愈合过程。据报道,全身或局部应用皮质类固醇有益于改善 FESS 后的鼻腔伤口愈合。然而,很少有研究调查术后全身类固醇对鼻腔伤口愈合的影响与组织学变化。本研究旨在评估全身地塞米松对内窥镜鼻窦手术后机械损伤后鼻腔愈合的影响。
使用刷洗技术在 4 周龄的 Sprague-Dawley 大鼠(n = 70)的鼻腔中引起单侧伤口。在受伤后,实验组(n = 35)和对照组(n = 35)分别给予地塞米松(0.15 mg/kg,每日一次,持续 7 天)和生理盐水腹腔注射。在受伤后第 2、5、14、28 和 42 天,每组处死 7 只大鼠。使用苏木精和伊红以及 Masson 三色染色法检查和比较鼻黏膜的组织学变化。
实验组在伤口愈合早期显示出较少的黏膜下水肿形成和上皮排列紊乱。实验组和对照组之间的黏膜下厚度和上皮厚度指数存在统计学上的显著差异(p < 0.05)。实验组的纤毛和杯状细胞指数较低,这意味着地塞米松可能延迟纤毛和杯状细胞的再生(p < 0.05)。两组之间的黏膜下纤维化指数没有差异。只有对照组发现鼻中隔和鼻甲之间有粘连形成。
黏膜损伤后全身应用地塞米松可能减轻黏膜下水肿、杯状细胞增生和粘连形成;然而,它可能导致黏膜纤毛再生延迟。