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2010 ; 24
(2
): 110-20
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Neuropathology of the olfactory mucosa in chronic rhinosinusitis
#MMPMID20021743
Yee KK
; Pribitkin EA
; Cowart BJ
; Vainius AA
; Klock CT
; Rosen D
; Feng P
; McLean J
; Hahn CG
; Rawson NE
Am J Rhinol Allergy
2010[Mar]; 24
(2
): 110-20
PMID20021743
show ga
BACKGROUND: Chronic rhinosinusitis (CRS) is a complex heterogeneous inflammatory
disease that affects the nasal cavity, but the pathological examination of the
olfactory mucosa (OM) in this disease has been limited. METHODS: Nasal biopsy
specimens were obtained from 20 control subjects and 50 CRS patients in
conjunction with clinical assessments. Histopathology of these nasal biopsy
specimens was performed and immunohistochemistry was used to characterize
nonneuronal, neuronal, and inflammatory cells in the OM. These OM characteristics
were then evaluated to determine the degree to which pathological features may be
related to smell loss in CRS. RESULTS: Histopathological examination of control
and CRS OM revealed changes in the normal pseudostratified olfactory epithelium
(OE): intermixing of goblet cells, metaplasia to squamous-like cells, and erosion
of the OE. Lower percentages of normal epithelium and olfactory sensory neurons
were found in CRS OE compared with controls. Relative to other CRS patients,
those with anosmia had the greatest amount of OE erosion, the highest density of
eosinophils infiltrating the OE, and exhibited the most extensive abnormalities
on CT and endoscopic examination, including being significantly more likely to
exhibit nasal polyposis. CONCLUSION: Our results suggest that OM pathology
observed in nasal biopsy specimens can assist in understanding the degree of
epithelial change and sensorineural damage in CRS and the potential for olfactory
loss.
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