Maurizi M, Ottaviani F, Paludetti G, Almadori G, Zappone C
Int J Pediatr Otorhinolaryngol. 1984 Oct;8(1):31-41. doi: 10.1016/s0165-5876(84)80023-3.
The authors have studied nasal mucociliary function and adenoid surface characteristics in a group of 86 children, aged between 4 and 10 years, divided in two groups according to the presence or absence of clinical, instrumental and röntgenographic signs of nasal obstruction due to hypertrophied adenoids. Each group was divided into 3 age-related subgroups (group I: 4-5 years; group II: 6-7 years; group III: 8-10 years). A population of normal adults was chosen both for functional and ultrastructural characteristics. Nasal mucociliary clearance velocity values were evaluated by means of the saccharine method and the surface characteristics of the adenoid tissue by means of scanning electron microscopy. The data obtained show that the nasal mucociliary function is generally reduced in children but, while in the group with poorly developed adenoids an early and progressive improvement can be observed, the children with severely hypertrophied adenoids show an impaired function up to 10 years, without age-related improvements. At almost 10 years, children with poorly developed adenoids reach normal adult clearance values. These functional data can be related to the surface characteristics of adenoid tissue. In fact, while poorly developed adenoids are characterized by a compact layer of ciliated cells, severely hypertrophied adenoids are characterized by a metaplasic epithelium, with almost complete loss of cilia. Such findings, which are probably due to the inflammatory events frequently complicating adenoid hypertrophy, could explain, together with the obstructive effects, the impairment of the nasal mucociliary clearance in childhood.
作者对86名4至10岁的儿童进行了鼻黏液纤毛功能和腺样体表面特征的研究，这些儿童根据是否存在因腺样体肥大导致鼻阻塞的临床、仪器检查和X线表现分为两组。每组又分为3个与年龄相关的亚组（第一组：4 - 5岁；第二组：6 - 7岁；第三组：8 - 10岁）。选取了一组正常成年人作为功能和超微结构特征的对照。通过糖精法评估鼻黏液纤毛清除速度值，并通过扫描电子显微镜观察腺样体组织的表面特征。所获得的数据表明，儿童的鼻黏液纤毛功能总体上有所降低，但是，在腺样体发育不良的组中可以观察到早期且逐渐改善的情况，而腺样体严重肥大的儿童在10岁之前功能均受损，且未出现与年龄相关的改善。在接近10岁时，腺样体发育不良的儿童达到了正常成年人的清除值。这些功能数据与腺样体组织的表面特征有关。实际上，腺样体发育不良的特征是有一层紧密的纤毛细胞层，而腺样体严重肥大的特征是化生上皮，几乎完全失去纤毛。这些发现可能是由于腺样体肥大经常并发的炎症事件导致的，与阻塞性影响一起，可以解释儿童期鼻黏液纤毛清除功能的受损情况。
