Effect of functional endoscopic sinus surgery on the maxillary sinus mucosa

• Published in: Otolaryngology-head and neck surgery 2004-08, Vol.131 (2), p.P269-P269
• Main Authors: Anselmo-Lima, Wilma T., Valera, Fabiana Cardoso Pereira, Demarco, Ricardo Cassiano, de Mello, Valder Rodrigues
• Format: Article
• Language: English
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1016/j.otohns.2004.06.563

Objectives: The exact physiopathology of chronic rhinosinusitis (CR), associated or not with nasosinusal polyposis, is still unknown. Methods: Thirty patients with CR and nasosinusal polyposis were evaluated for morphological alterations of the maxillary sinus mucosa. The patients were divided into 3 groups. Biopsies were collected during surgery (group 1) and 1 year thereafter during a second surgery, from patients with recurrent disease (group 2) and patients showing clinical cure (group 3). Biopsy material from 4 cadavers was used as control. Results: Group 1 patients presented clearly visible histopathological alterations: normal respiratory epithelium but with an inflammatory process infiltrating the submucosa (N = 2), atypical respiratory epithelium accompanied by an important increase in the number of goblet cells (N = 2), metaplasia (N = 3), and a mixed epithelium (N = 3). Inflammation of variable degree infiltrating the submucosa was observed in all cases. Group 2 patients showed the same alterations but accompanied by ciliary dysmorphy in all cases. A normal respiratory epithelium was observed in all patients of group 3, with areas containing an increased number of goblet cells being identified in 2 patients, a reduction in the number of ciliated cells and cilia in 2 other patients, and ciliary morphological alterations in 1 patient. Conclusion: This study demonstrates that recovery of the maxillary sinus mucosa of patients with CR is incomplete 1 year after endoscopic surgery, indicating the need for continuous follow-up of these patients.