Abstract
The effect of functional endoscopic sinus surgery (FESS) was evaluated in 20 patients with chronic sinusitis. The physiological function of sinus mucosa and its mucociliary transport mechanism was assessed pre and post operatively in patients undergoing FESS by performing Saccharin clearance test. The effect of functional sinus surgery on nasal mucosa was evaluated using scanning electron microscopy and study of the ultrastructure of cilia in pre and post operative patients and correlation with histopathological examination. The mucociliary transport mechanism of the sinus mucosa improved 6 weeks following surgery. Histopathologically there was evidence of improvement in the ciliary population and decrease in inflammation, ulceration, fibrosis, vascular congestion, edema, squamous cell metaplasia, basement membrane thickening and polyp formation in comparison to the diseased mucosa sampled preoperatively. Scanning electron microscopic examination revealed considerable increase in the ciliary area as well as the orientation of cilia. Subjective improvement 6 weeks following surgery was confirmed by decrease in saccharin test time. This study revealed that FESS is an effective surgical procedure in chronic sinusitis and improves the overall function of the sinuses
Keywords: Functional Endoscopic Sinus Surgery, FESS, Mucociliary transport, Saccharin test, Ultra structure of cilia, Nasal mucosa, Chronic Sinusitis
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References
- 1.Halma A.R. Density of epithelial cells in normal human nose and the paranasal sinus mucosa, A scanning electron microscopic study. Rhinoiogy. 1990;28:25–32. [PubMed] [Google Scholar]
- 2.Levine H.L., et al. FESS; Evaluation, surgery and follow-up of 250 patients. Laryngoscope. 1990;100:79–88. doi: 10.1288/00005537-199001000-00016. [DOI] [PubMed] [Google Scholar]
- 3.Ahmed Bassiouny M.D., et al. Ultrastructural ciliary changes of maxillary sinus mucosa following FESS — An image analysis quantitative study. J Lo. 2003;117:273–279. doi: 10.1258/00222150360600878. [DOI] [PubMed] [Google Scholar]
- 4.Forsgren K., et al. Regeneration of Maxillary sinus mucosa following surgical removal: experimental studies in rabbits. Ann Otol Rhinol Laryngol. 1993;102:459–466. doi: 10.1177/000348949310200610. [DOI] [PubMed] [Google Scholar]
- 5.Haque M.R., Hossain M.M., Kundu S.C., Kabir S., Alam S., Chowdhury W.A., Faruque A study of Endoscopic sinus surgery technique. Mymensingh Med J. 2004;13(1):39–42. [PubMed] [Google Scholar]
- 6.Guo Y., et al. Effect of functional endoscopic sinus surgery on maxillary sinus mucosa. Arch Otolaryngol. 1997;123:1097–1100. doi: 10.1001/archotol.1997.01900100073010. [DOI] [PubMed] [Google Scholar]
- 7.Forsgren K., et al. Endoscopic and Caldwell-luc approaches in chronic maxillary sinusitis: A comparative histopathological study on preoperative and postoperative mucosal morphology. Ann Otol Rhinol Laryngol. 1995;104:350–357. doi: 10.1177/000348949510400503. [DOI] [PubMed] [Google Scholar]
- 8.Willems T., Jorissen M. Correlation between ciliary structure and ciliary function. Acta Otorhinolaryngol Belg. 2000;54:299–308. [PubMed] [Google Scholar]
- 9.Rossman C.M., Lee R.M., Forrest J.B., et al. Nasal ciliary ultrastructure and function in patients with primary ciliary dyskinesia compared with that in normal subjects and in subjects with various respiratory diseases. Am Rev Respir Dis. 1984;129:161–167. doi: 10.1164/arrd.1984.129.1.161. [DOI] [PubMed] [Google Scholar]
- 10.Smallman L.A. Gregory. Ultrastructural abnormalities of cilia in the human respiratory tract. Hum Pathol. 1986;17:848–855. doi: 10.1016/S0046-8177(86)80206-4. [DOI] [PubMed] [Google Scholar]
