Min Y G, Kim I T, Park S H
Department of Otolaryngology, College of Medicine, Seoul National University, Korea.
Laryngoscope. 1994 Dec;104(12):1482-6. doi: 10.1288/00005537-199412000-00010.
The purpose of this study was to observe histologic findings in the regenerated maxillary sinus mucosa and restoration of ciliary activity by measuring the speed of mucociliary transport after complete surgical removal of the maxillary sinus mucosa. The maxillary sinuses of 32 rabbits were opened anteriorly and one side of the sinus mucosa of each animal was completely removed. In 16 animals, the natural ostia were widened, and, in another 16 animals, the natural ostia were left undisturbed. The contralateral, sham-operated sinus was used as a control for each animal. The animals of each group were reanesthetized and the maxillary sinuses were reopened at planned intervals. The speed of mucociliary transport toward the maxillary ostium, determined by India ink particle movement, was reduced to 6.4 mm/min, whereas it was 10.8 mm/min in the control side. Beating cilia were observed in 16% by dark-field microscopy, in contrast to 66% in the control sinus. Pseudostratified columnar epithelia without cilia were present in 12%, with the remaining consisting of pseudostratified ciliated columnar epithelia (88%). Light microscopic examination showed increase in submucosal fibrotic proliferation, decrease in submucosal glands, and infiltration of inflammatory cells. Under transmission electron microscopy, abnormal cilia such as compound cilia or edematous cilia were frequently found in the regenerated specimens. These observations suggest that mucociliary clearance of the regenerated sinus mucosa may be significantly diminished compared with that of the original mucosa.
本研究的目的是通过在完全手术切除上颌窦黏膜后测量黏液纤毛运输速度，观察再生上颌窦黏膜的组织学发现以及纤毛活性的恢复情况。32只兔子的上颌窦从前部打开，每只动物一侧的窦黏膜被完全切除。在16只动物中，自然开口被扩大，在另外16只动物中，自然开口未受干扰。每只动物对侧的假手术窦用作对照。每组动物再次麻醉，并在计划的时间间隔重新打开上颌窦。通过印度墨汁颗粒移动确定的朝向筛漏斗的黏液纤毛运输速度降至6.4毫米/分钟，而对照侧为10.8毫米/分钟。暗视野显微镜观察发现16%的标本中有摆动的纤毛，而对照窦中为66%。12%的标本存在无纤毛的假复层柱状上皮，其余由假复层纤毛柱状上皮组成（88%）。光镜检查显示黏膜下纤维化增生增加、黏膜下腺体减少以及炎性细胞浸润。在透射电子显微镜下，再生标本中经常发现复合纤毛或水肿纤毛等异常纤毛。这些观察结果表明，与原始黏膜相比，再生窦黏膜的黏液纤毛清除功能可能显著降低。
