Pinna Fabio de Rezende, Ctenas Bruno, Weber Raimar, Saldiva Paulo Hilario, Voegels Richard Louis
PhD. Faculty Member of Department of Otorhinolaryngology, Clinics Hospital, School of Medicine, University of São Paulo, São Paulo, Brazil.
MD (medical doctor). Department of Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil.
Int Arch Otorhinolaryngol. 2013 Apr;17(2):131-8. doi: 10.7162/S1809-97772013000200004.
Olfactory neuroepithelium (ON) biopsy has several therapeutic applications for both disorders of olfaction and neurodegenerative diseases. Successful collection of ON is still anything but routine due to a dearth of studies on the distribution of ON in the superior and middle turbinates.
To determine the location in which ON is most likely to be present in endoscopically removed cadaver superior and middle turbinates as well as the influences of gender, age, and naris side on the presence of ON and the extent to which it is present.
We conducted a prospective anatomical study. The superior and middle turbinates on both sides endoscopically removed from 25 fresh cadavers (less than 12 h post-mortem). The turbinates were halved into anterior and posterior segments for a total of 200 specimens, which were analyzed after hematoxylin and eosin and immunohistochemical staining. Hematoxylin and eosin-stained slides were subjected to blind examination by 3 independent pathologists, and the presence of ON was graded on a 5-point scale from 0 to 4. Kappa measurement was used to determine the agreement between pairs of observers.
ON was present in 82.9% of superior turbinate samples and in 17.1% of middle turbinate samples. Immunohistochemistry detected ON in superior turbinates only by S-100 staining and only in 15 fragments. Gender, age, and naris side had no statistically significant effects on the presence of ON.
When biopsying ON, the posterior portion of the superior turbinate should be targeted whenever possible because it has the highest concentration of ON among the nasal structures.
嗅神经上皮（ON）活检在嗅觉障碍和神经退行性疾病的治疗中具有多种应用。由于关于ON在上鼻甲和中鼻甲分布的研究匮乏，成功采集ON仍远非常规操作。
确定在内窥镜下切除的尸体上鼻甲和中鼻甲中ON最可能存在的位置，以及性别、年龄和鼻孔侧别对ON存在情况及其存在程度的影响。
我们进行了一项前瞻性解剖学研究。从25具新鲜尸体（死后不到12小时）的双侧内窥镜下切除上鼻甲和中鼻甲。将鼻甲分为前后段，共得到200个标本，经苏木精-伊红染色和免疫组织化学染色后进行分析。苏木精-伊红染色切片由3名独立病理学家进行盲法检查，ON的存在情况按0至4的5分制评分。使用kappa测量法确定观察者之间的一致性。
82.9%的上鼻甲样本中存在ON，17.1%的中鼻甲样本中存在ON。免疫组织化学仅通过S-100染色在上鼻甲中检测到ON，且仅在15个片段中检测到。性别、年龄和鼻孔侧别对ON的存在情况无统计学显著影响。
活检ON时，应尽可能以上鼻甲后部为目标，因为它是鼻腔结构中ON浓度最高的部位。
