Department of Clinical Surgery, Londrina State University (UEL), Londrina, PR, Brazil.
Laboratory of Pain, Inflammation, Neuropathy and Cancer, Department of Pathological Sciences, UEL, Londrina, PR, Brazil.
Eur Arch Otorhinolaryngol. 2020 Feb;277(2):483-492. doi: 10.1007/s00405-019-05728-7. Epub 2019 Nov 16.
There is no standardized approach for preserving olfactory function in the side of the nose where biopsy of the olfactory epithelium (OE) is performed. Moreover, a gold standard technique for obtaining human OE in vivo is still lacking. We determined the efficacy of obtaining good-quality OE specimens suitable for pathological analysis from the lower half of the superior turbinate and verified the safety of this procedure in maintaining bilateral and unilateral olfactory function.
In 21 individuals without olfactory complaints and who had undergone septoplasty and inferior turbinectomy OE biopsy was made during septoplasty. Olfactory function, both unilateral and bilateral, was assessed using the University of Pennsylvania Smell Identification Test (UPSIT) before and 1 month after the procedure. Specimens were marked with the olfactory marker protein for confirmation of OE presence.
Ninety percent of the samples contained OE, although clear histological characterization was possible from only 62%. There was no deterioration of UPSIT scores either bilaterally or unilaterally on the side of the biopsy. Patients also maintained the ability to identify individual odorants.
Biopsies of the lower half of the superior turbinate do not affect olfactory function and show strong efficacy in yielding OE tissue and moderate efficacy for yielding tissue appropriate for morphological analysis. Future studies are needed to assess the safety of this procedure in other OE regions.
在进行嗅上皮(OE)活检的鼻腔一侧,目前尚无标准化的方法来保留嗅觉功能。此外,仍然缺乏获得活体人 OE 的金标准技术。我们确定了从下鼻甲的下半部分获得适合病理分析的高质量 OE 标本的有效性,并验证了该程序在维持双侧和单侧嗅觉功能方面的安全性。
在 21 名无嗅觉抱怨且接受过鼻中隔成形术和下鼻甲切除术的个体中,在鼻中隔成形术中进行 OE 活检。使用宾夕法尼亚大学嗅觉识别测试(UPSIT)在手术前和手术后 1 个月评估双侧和单侧嗅觉功能。使用嗅觉标记蛋白对标本进行标记以确认 OE 的存在。
90%的样本含有 OE,但只有 62%的样本能够进行明确的组织学特征描述。在活检侧,UPSIT 评分无论是双侧还是单侧均无恶化。患者也能够识别单个气味。
下鼻甲下半部分的活检不会影响嗅觉功能,并且在获取 OE 组织方面具有很强的效果,在获取适合形态分析的组织方面具有中等效果。需要进一步研究来评估该程序在其他 OE 区域的安全性。