Department of Otolaryngology, Alexandria Medical School, Alexandria, Egypt.
Laryngoscope. 2012 May;122(5):965-9. doi: 10.1002/lary.23246. Epub 2012 Mar 23.
OBJECTIVES/HYPOTHESIS: Passive exposure to cigarette smoke has been implicated in a number of respiratory childhood disorders. Most studies concerning smoking were directed to its carcinogenic effect on the lungs. However, the effects of smoking on nasal respiratory mucosa have not been widely studied. The aim of the present study was, therefore, to study the ultrastructural changes in the nasal mucosa of a pediatric population exposed to passive smoking.
The study included 20 children between the ages of 5 and 11 years, who were scheduled for tonsillectomy and at the same time had a positive history of prolonged exposure to household passive smoke. Another 10 children with a negative household smoking history were included as a control group. All children were nonatopic and with a negative family history of allergy. None of them had adenoids or infective rhinosinusitis.
At the time of surgery, a 1-mm(3) biopsy was taken was taken from the lower border of the inferior turbinate. The specimens were processed and examined with electron microscopy
Examination of the nasal mucosa showed several ultrastructural changes. These included patchy loss of cilia, generalized loss of cilia, squamous metaplasia, hyperplasia of goblet cells and seromucinous acini, and vascular congestion. More severe changes were observed with longer passive exposures to cigarette smoke. The study did not disclose any evidence of ongoing allergic reaction or neoplastic transformations.
Children exposed to passive cigarette smoke may develop several structural changes in the respiratory nasal mucosa with subsequent negative effects on its ciliary activity and mucociliary function. As a result of these effects, defense mechanisms of the nose may be ruined or lost, and those children may develop persistent sinonasal infections. Exposure of these children to passive smoking for longer periods of time may also induce other significant changes that were not detected in the present study.
目的/假设：被动吸烟已被牵连到许多儿童呼吸道疾病中。大多数关于吸烟的研究都集中在其对肺部的致癌作用上。然而，吸烟对鼻腔呼吸道黏膜的影响尚未得到广泛研究。本研究的目的是研究暴露于被动吸烟的儿科人群鼻腔黏膜的超微结构变化。
该研究纳入了 20 名年龄在 5 至 11 岁之间的儿童，他们计划进行扁桃体切除术，同时有长期暴露于家庭被动吸烟的阳性史。另选 10 名有家庭吸烟史的儿童作为对照组。所有儿童均非特应性，且无过敏家族史。他们中没有腺样体肥大或感染性鼻-鼻窦炎。
在手术时，从下鼻甲下缘切取 1mm(3)的活检。将标本进行处理并使用电子显微镜检查。
鼻腔黏膜检查显示出多种超微结构变化。这些变化包括纤毛局灶性缺失、纤毛普遍性缺失、鳞状上皮化生、杯状细胞和浆液黏液腺增生以及血管充血。暴露于被动吸烟时间更长的儿童，其变化更为严重。研究未发现任何正在进行的过敏反应或肿瘤转化的证据。
暴露于被动吸烟的儿童可能会在呼吸道鼻腔黏膜中出现多种结构变化，随后对其纤毛活动和黏液纤毛功能产生负面影响。由于这些影响，鼻子的防御机制可能会被破坏或丧失，这些儿童可能会发展为持续性鼻-鼻窦感染。这些儿童长期暴露于被动吸烟可能还会引起本研究未检测到的其他显著变化。
