Department of Otolaryngology, Alexandria Faculty of Medicine, Alexandria, Egypt.
Pathology Department, Alexandria Faculty of Medicine, Alexandra, Egypt.
Eur Arch Otorhinolaryngol. 2020 Jun;277(6):1691-1698. doi: 10.1007/s00405-020-05896-x. Epub 2020 Mar 12.
Smoking, whether active or passive, has proven deleterious effects on the nasal mucosa. There is also a link between smoking and development and/or maintenance of chronic rhinosinusitis (CRS). Reversal of smoking-induced mucosal changes after quitting smoking is still unconfirmed and controversial. The present study investigated the possibility of reversal of smoking-related nasal mucosal changes back to normal after completely quitting smoking.
The study was performed on 32 smokers whose nasal mucosa was previously biopsied for electron microscopic examination and then they completely quit smoking. Smoking history of the participants and duration of cessation of smoking were recorded. A tiny 1-mm3 biopsy was taken from the inferior turbinate 1 cm behind its anterior end and processed for electron microscopy. The specimens were processed for electron microscopy and the sections were examined by a pathologist who was blinded to the identity and smoking status of the participant. The results of electron microscopic examination of the nasal mucosa before and after quitting smoking were compared.
The mean duration of quitting smoking was 30.75 months (± 8.26). Examination of the electron microscopic sections before quitting smoking showed variable degrees of loss of cilia and columnar cells, edema between the epithelial cells, few goblet cells, hyperplasia of seromucinous acini, and vascular congestion. The pathologic changes correlated positively with the smoking index of the participant. On the other hand, the sections after quitting smoking showed variable degrees of regeneration of the ciliated cells and decreased vascular congestion. Numerous goblet cells and seromucinous acini were seen. Less pathologic changes were observed with longer durations of cessation of smoking.
The present study showed an association between smoking and the nasal mucosa. Smoking has several injurious effects on the nasal mucosa. However, the nasal mucosa has excellent regeneration potentials and quitting smoking for sufficient periods of time may reverse these deleterious changes. Considering the established link between smoking and CRS, quitting smoking may help smokers to overcome their recalcitrant disease. This should be further investigated.
吸烟，无论是主动还是被动，都已被证实对鼻黏膜有有害影响。吸烟与慢性鼻-鼻窦炎（CRS）的发生和/或维持之间也存在关联。戒烟后吸烟引起的黏膜变化是否能逆转仍未得到证实，存在争议。本研究旨在调查完全戒烟后，吸烟相关鼻黏膜变化恢复正常的可能性。
对 32 名吸烟者进行了研究，这些吸烟者的鼻黏膜先前已被活检用于电子显微镜检查，然后他们完全戒烟。记录了参与者的吸烟史和戒烟持续时间。从前鼻嵴后 1cm 处的下鼻甲上取下 1mm3 的小活检，并进行电子显微镜检查。将标本进行电子显微镜处理，由一名对参与者的身份和吸烟状况均不知情的病理学家检查切片。比较了戒烟前后鼻黏膜的电子显微镜检查结果。
平均戒烟时间为 30.75 个月（±8.26）。戒烟前的电子显微镜切片检查显示，纤毛和柱状细胞不同程度缺失、上皮细胞之间水肿、杯状细胞较少、浆液黏液腺增生和血管充血。病理变化与参与者的吸烟指数呈正相关。另一方面，戒烟后的切片显示纤毛细胞的再生程度不同，血管充血减少。可见大量杯状细胞和浆液黏液腺。戒烟时间越长，观察到的病理变化越少。
本研究表明吸烟与鼻黏膜之间存在关联。吸烟对鼻黏膜有多种损害作用。然而，鼻黏膜具有极好的再生潜能，戒烟足够长的时间可能会逆转这些有害变化。鉴于吸烟与 CRS 之间的既定联系，戒烟可能有助于吸烟者克服其顽固的疾病。这需要进一步研究。
