Deitmer T
University ENT Clinic, University of Münster.
Adv Otorhinolaryngol. 1989;43:1-136.
After a short historical introduction, the current state of knowledge of the anatomy and physiology of the mucociliary system is reviewed. Description and discussion of the clinical and experimental methods of investigation and measurement of the mucociliary transport and of the ciliary activity then follow. Light and electron microscopy are also considered. Next, the pathology, pathophysiology and pharmacology of the mucociliary system are reported. The introduction ends with the consideration of specific diseases related to the mucociliary system, such as the immotile cilia syndrome. The main interest of this investigation is directed to changes in the ciliary epithelium in laryngeal malignancies. Therefore the literature relevant to physiology is critically evaluated. Pilot studies of the method used for investigating the physiology of the ciliary epithelium were mainly undertaken on the more accessible nasal mucosa as a model for ciliary epithelium. The use of the saccharin test for demonstration of nasal mucociliary transport is thoroughly assessed and the suitability of a new, improved, marking substance was tested. The quantification of cell types for cytological assessment of nasal smears under the phase contrast microscope was appraised. The method of determination of ciliary frequency by microphotometry was evaluated critically by a series of experiments. The author's electron microscopic findings on ciliary epithelium taken from human larynges affected with cancer are also discussed. After these pilot studies the method of the saccharin test and the cytological smear appeared to be unsuitable for oncological investigations. Therefore, mucociliary transport in the subglottic space of 75 human larynges excised for malignancy was investigated by the development of a suitable method. This method demonstrated abnormal mucociliary transport pathways. Investigations of the normal pathway of mucociliary transport in the larynx were obtained in animal experiments and by endoscopic investigations in man.
在简短的历史介绍之后，回顾了黏液纤毛系统解剖学和生理学的当前知识状态。接着描述并讨论了黏液纤毛运输和纤毛活动的临床及实验研究与测量方法。还考虑了光学显微镜和电子显微镜。接下来，报告了黏液纤毛系统的病理学、病理生理学和药理学。引言最后考虑了与黏液纤毛系统相关的特定疾病，如不动纤毛综合征。本研究的主要兴趣在于喉恶性肿瘤中纤毛上皮的变化。因此，对相关生理学文献进行了批判性评估。用于研究纤毛上皮生理学的方法的初步研究主要在更容易获取的鼻黏膜上进行，将其作为纤毛上皮的模型。对用于证明鼻黏液纤毛运输的糖精试验进行了全面评估，并测试了一种新的、改进的标记物质的适用性。评估了在相差显微镜下对鼻涂片进行细胞学评估时细胞类型的定量方法。通过一系列实验对用显微光度测定法测定纤毛频率的方法进行了批判性评估。还讨论了作者对取自患癌人类喉部的纤毛上皮的电子显微镜观察结果。经过这些初步研究，糖精试验和细胞学涂片方法似乎不适用于肿瘤学研究。因此，通过开发一种合适的方法，对75例因恶性肿瘤而切除的人类喉部声门下间隙的黏液纤毛运输进行了研究。该方法显示了异常的黏液纤毛运输途径。通过动物实验和人体内镜检查获得了喉部黏液纤毛运输正常途径的研究结果。
