Aksoy F, Yildirim Y S, Demirhan H, Özturan O, Solakoglu S
Department of Otorhinolaryngology and Head and Neck Surgery, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey.
J Laryngol Otol. 2012 Jan;126(1):38-42. doi: 10.1017/S0022215111002404. Epub 2011 Sep 5.
During nasal septum surgery, elevation of mucoperichondrium from the anterior nasal septum may be more difficult than from the medial and posterior septum. This study aimed to evaluate any histological structural differences between the anterior and posterior nasal septum cartilage, mucoperichondrium and intervening tissue.
Unilateral mucoperichondrial flap elevation without infiltration was performed, after nasal tip and dorsum decortication, in four patients undergoing open septorhinoplasty. Full-thickness samples, including cartilage and mucoperichondrium, were removed from the anterior and posterior nasal septum and examined under light and electron microscopy.
Light microscopy showed no difference between anterior and posterior septum specimens regarding perichondrial thickness and subperichondrial cell density. Demarcation between cartilage and perichondrium and between perichondrium and lamina propria was more regular in the posterior versus the anterior septum. Electron microscopy showed no difference in chondroblast activity at the two sites.
The observed tissue demarcation irregularities may explain the greater reported difficulty in elevating anterior versus posterior nasal septum mucoperichondrium. Immunohistochemical examination would further elucidate these interstructural connections.
在鼻中隔手术中，从鼻中隔前部掀起黏骨膜可能比从中部和后部更困难。本研究旨在评估鼻中隔前部和后部软骨、黏骨膜及中间组织之间的组织学结构差异。
对4例接受开放式鼻中隔鼻整形术的患者，在鼻尖和鼻背去皮后，进行单侧不浸润的黏骨膜瓣掀起。从前部和后部鼻中隔取出包括软骨和黏骨膜的全层样本，在光镜和电镜下检查。
光镜显示，前部和后部鼻中隔标本在软骨膜厚度和软骨膜下细胞密度方面无差异。与前部鼻中隔相比，后部鼻中隔软骨与软骨膜之间以及软骨膜与固有层之间的分界更规则。电镜显示两个部位的成软骨细胞活性无差异。
观察到的组织分界不规则可能解释了据报道从鼻中隔前部掀起黏骨膜比从后部更困难的原因。免疫组化检查将进一步阐明这些结构间的联系。
