Sakthikumar K R V, Ravikumar A, Mohanty Sanjeev, Senthil K, Somu L, Kuruvilla Sarah
Department of Otorhinolaryngology-Head and Neck Surgery, Sri Ramachandra Medical College & Research Institute, Porur, Chennai, 600 116 Tamil Nadu India.
Indian J Otolaryngol Head Neck Surg. 2008 Mar;60(1):1-6. doi: 10.1007/s12070-008-0004-2. Epub 2008 Apr 3.
The effect of functional endoscopic sinus surgery (FESS) was evaluated in 20 patients with chronic sinusitis. The physiological function of sinus mucosa and its mucociliary transport mechanism was assessed pre and post operatively in patients undergoing FESS by performing Saccharin clearance test. The effect of functional sinus surgery on nasal mucosa was evaluated using scanning electron microscopy and study of the ultrastructure of cilia in pre and post operative patients and correlation with histopathological examination. The mucociliary transport mechanism of the sinus mucosa improved 6 weeks following surgery. Histopathologically there was evidence of improvement in the ciliary population and decrease in inflammation, ulceration, fibrosis, vascular congestion, edema, squamous cell metaplasia, basement membrane thickening and polyp formation in comparison to the diseased mucosa sampled preoperatively. Scanning electron microscopic examination revealed considerable increase in the ciliary area as well as the orientation of cilia. Subjective improvement 6 weeks following surgery was confirmed by decrease in saccharin test time. This study revealed that FESS is an effective surgical procedure in chronic sinusitis and improves the overall function of the sinuses.
对20例慢性鼻窦炎患者评估了功能性鼻内镜鼻窦手术（FESS）的效果。通过进行糖精清除试验，对接受FESS手术的患者术前和术后鼻窦黏膜的生理功能及其黏液纤毛转运机制进行了评估。利用扫描电子显微镜以及对手术前后患者纤毛超微结构的研究，并与组织病理学检查相关联，评估了功能性鼻窦手术对鼻黏膜的影响。鼻窦黏膜的黏液纤毛转运机制在术后6周得到改善。组织病理学显示，与术前采集的病变黏膜相比，纤毛数量增加，炎症、溃疡、纤维化、血管充血、水肿、鳞状上皮化生、基底膜增厚和息肉形成减少。扫描电子显微镜检查显示纤毛区域以及纤毛方向有显著增加。术后6周糖精试验时间缩短证实了主观上的改善。本研究表明，FESS是治疗慢性鼻窦炎的有效手术方法，可改善鼻窦的整体功能。
