Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia; I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russia; K.A. Raukhfus Childrens City Multidisciplinary Clinical Center for High Medical Technologies, St. Petersburg, Russia.
Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia; K.A. Raukhfus Childrens City Multidisciplinary Clinical Center for High Medical Technologies, St. Petersburg, Russia; First Pavlov State Medical University of Saint Petersburg, St. Petersburg, Russia.
Rhinology. 2021 Jun 1;59(3):319-327. doi: 10.4193/Rhin20.642.
The objective of the study is evaluation of ciliary function and mucosal cytology after endoscopic sinus surgery in children with chronic rhinosinusitis (CRS).
A total of 132 children with CRS who underwent endoscopic sinus surgery, as well as 15 healthy controls were involved in the study. In this follow-up study patients were examined preoperatively, as well as 3, 6, 9, and 12 months after endoscopic sinus surgery. Assessment of ciliary function and sinonasal mucosal cytology was performed using high-speed videomicroscopy. Lund-Kennedy, Lund-Mackay, and sinonasal outcome test 20 (SNOT20) scores were also evaluated.
Total SNOT-20, Lund-Mackay, and Lund-Kennedy values significantly decreased after sinus surgery. In contrast, ciliary function and mucosal cytology only tended to improve after 6 months. 9 months after surgery the number of ciliated cells, ciliary beat frequency, cell viability, and ciliary length were significantly higher than preoperatively. The most significant improvement of ciliary function and cell height was observed 12 months after operation, whereas epithelial dystrophy and neutrophil infiltration were significantly reduced.
Substantial improvement was observed only in a year after surgery, whereas 0 to 3 months after the surgery ciliary function was severely impaired thus predisposing to recurrent sinusitis or other complications.
本研究旨在评估儿童慢性鼻-鼻窦炎（CRS）内镜鼻窦手术后的纤毛功能和黏膜细胞学变化。
本研究共纳入 132 例接受内镜鼻窦手术的 CRS 患儿和 15 例健康对照者。在这项随访研究中，患者在术前以及内镜鼻窦手术后 3、6、9 和 12 个月接受检查。使用高速视频显微镜评估纤毛功能和鼻黏膜细胞学。还评估了 Lund-Kennedy、Lund-Mackay 和鼻-鼻窦炎生活质量量表 20 项（SNOT20）评分。
鼻窦手术后总 SNOT-20、Lund-Mackay 和 Lund-Kennedy 评分显著降低。相比之下，纤毛功能和黏膜细胞学仅在 6 个月后趋于改善。术后 9 个月，纤毛细胞数量、纤毛摆动频率、细胞活力和纤毛长度显著高于术前。术后 12 个月，纤毛功能和细胞高度的改善最为显著，而上皮细胞异常和中性粒细胞浸润显著减少。
仅在手术后 1 年内观察到明显改善，而术后 0 至 3 个月纤毛功能严重受损，易导致复发性鼻窦炎或其他并发症。
