Features of the inflammatory process of the nasal mucous membrane and paranasal sinuses in patients with chronic rhinosinusitis with nasal polyps

Abstract

Objectives to assess the features of the inflammatory process of the nasal mucous membrane and sinuses in patients with сhronic rhinosinusitis with nasal polyps (CRSwNP). Material and methods. We analyzed the results of examination of 44 patients with CRSwNP. The objects of investigation were smears-reprints from the mucous membrane of the middle turbinate (rhinocytograms) and the intensity of the extracellular peroxidase activity of the lavage fluids of the maxillary sinuses. The data obtained were processed using the Statistica 8.0 software. Results. When analyzing rhinocytograms of the mucous membrane of the middle turbinates, the epithelial type of rhinocytogram was most often detected in 65.9% of cases (epithelial cells more than 50%); the eosinophilic type in 22.7% (eosinophils more than 1%) and smears with mast cells in 4.6% of cases; the neutrophilic type was less frequent (neutrophils more than 50%) 6.8% of cases. In 34.1% of patients, the cells of the columnar epithelium had pronounced changes in the cytoplasm (vacuolization and enzymatic activity); and in 38.6% of cases the gross pathology was recorded directly in the nucleus of the cells (nucleoli, granules, destruction of the nucleus). The revealed pathology of the cell nucleus suggests the viral etiology of the development of productive inflammation in the nasal cavity and sinuses In the lavage fluids of the maxillary sinuses, a high intensity of extracellular peroxidase activity was recorded (1777.9132.4 a.u. compared to 1225.0190.9 a.u. in patients with chronic purulent rhinosinusitis and 1245.0362.3 a.u. in patients with purulent-polypous rhinosinusitis). Conclusion. Chronic rhinosinusitis with nasal polyps is accompanied by a pronounced inflammatory process of the nasal mucous membrane and paranasal sinuses in the form of structural and functional changes in the cells of the columnar epithelium and a high intensity of extracellular peroxidase activity. The epithelial nucleus damage (the presence of nucleoli, granules, destruction of the nucleus) suggests a viral nature with the development of productive inflammation in the nasal cavity and sinuses.

Keywords

• сhronic rhinosinusitis
• nasal polyps
• rhinocytogram
• inflammation
• immunity
• epithelium