Schenck N L, Rauchbach E
Laryngoscope. 1976 Nov;86(11):1726-33. doi: 10.1288/00005537-197611000-00018.
The pathogenesis of chronic frontal sinusitis is poorly understood. The canine frontal sinus model was developed to isolate experimentally the variables involved. We have recently determined that blockage of the naso-frontal duct does not, by itself, produce sinusitis or mucocele experimentally. The purpose of the present investigation is to examine the histological and ultrastructural responses of the sinus mucosa to artificially-induced infection. Bone wax was implanted in the canine frontal sinus via an osteoplastic flap, and subsequently removed three months later. Radiological, histological and ultrastructural analysis of the resultant infected mucosa was performed at periods up to one year. The sinus mucosa did not return to normal up to nine months following removal of the infection-inciting foreign body. Persistent changes included epithelial and submucosal thickening, polypoid degeneration, matting of the ciliary carpet, and "bursting" of the ciliary cell bodies. In the light of this and previous experiments, an insidious cycle of events leading to irreversible frontal sinus disease is postulated, requiring the interplay of at least three variables: the infectious insults, the response of the sinus mucosa, and the variable patency of the nasofrontal duct.
慢性额窦炎的发病机制目前尚不清楚。犬额窦模型的建立是为了通过实验分离出相关变量。我们最近发现，鼻额管阻塞本身并不会在实验中导致鼻窦炎或黏液囊肿。本研究的目的是研究鼻窦黏膜对人工诱导感染的组织学和超微结构反应。通过骨成形皮瓣将骨蜡植入犬额窦，三个月后取出。在长达一年的时间里，对由此产生的感染黏膜进行了放射学、组织学和超微结构分析。在去除引发感染的异物后九个月内，鼻窦黏膜仍未恢复正常。持续存在的变化包括上皮和黏膜下增厚、息肉样变性、纤毛毡层紊乱以及纤毛细胞体“破裂”。鉴于此实验及之前的实验，推测出一个导致不可逆额窦疾病的隐匿事件循环，这至少需要三个变量相互作用：感染性损伤、鼻窦黏膜的反应以及鼻额管的通畅程度变化。
