The Observation Of The Image And Pathological Characteristics Of Nasal Cavity Structure Of Patients With Deviated Nasal Septum

Objective: To compare the changes of shape, structure and mucosa pathological characteristics of middle and inferior turbinate in two sides of nose in patients with deviated nasal septum.Methods: 30 cases with deviated nasal septum were selected who have underdone the operation to redress the nasal septum deviation. Nasal sinus coronal CT was taken before operation. Single out the slice which can optimally display the ostiomeatal complex , in which to measure the height and width of middle and inferior turbinate. The mucosa samples of inferior turbinate were taken from the site where the nasal septum deviation is most obviously. The mucosa samples of middle turbinate were taken from its former end. The Pathological performance of mucosa samples were observed in optical microscope and transmission electron microscope.Results: It can be observed from the nasal sinus CT that the average width of middle turbinate in the opposite side of nasal septum deviation was 0.99 ±0.27 and was 0.79±0.23 in the same side. The difference was significant between tow groups (p<0.01). the average height of middle turbinate in the opposite side of nasal septum deviation was 1.34±0.28 and was 1.07 ±0.37 in the other side. There are significant difference between two groups (p<0.01). the average height of inferior turbinate in the opposite side of nasal septum deviation was 1.88±0.33 and was 1.57±0.37 in the other side. The difference was significant between two group (p<0.01). the average width of inferior turbinate in the opposite side of nasal septum deviation was 1.38± 0.29 and was 1.09±0.34 in the other side. The difference was significant between two groups (p<0.01). Observational result of optic microscope: comparing to the other side, in the opposite side of nasal septum deviation, the mucosa epithelium of the inferior turbinate was proliferation and hypertrophy, the basal lamina was incrassation, the blood vessel was proliferation and dilatation in mesenchyme, the cavity of blood vessel was more circuity, the fibre tissue was obviously proliferation and the density of gland was more smaller. The difference of number of inflammation cell in two sides was not significant. These results can also be found in middle turbinate except for the increase of the number of secretive cell and mucous gland cell, the observation result of transmission electron microscope: comparing to the other side, in the mucosa of inferior turbinate in the opposite side of nasal septum deviation, the collagenousfibers in the lamina propria was obviously proliferation. Fenestrated capillary was seen under the subepithelia vascular layers and around the gland. The basal lamian of small vein was limpidity, swell, loosen and the space was increase. These phenomena can also be found in middle turbinate. The change of inside structure of gland cell in inferior and middle turbinate in both sides was similar.Conclusions: the difference of the width and height of the inferior and middle turbinate in the patients with nasal septum deviation between two sides of nasal was significant. The factors contribute to the hypertrophy of inferior and middle turbinate in the opposite side of nasal septum deviation include osseous proliferation, mucous membrane proliferation and subepithelia vascular layers proliferation. In the operation to redress nasal septum deviation, the hypertrophy and proliferation of inferior and middle turbinate should not be ignored. Except removing the proliferous turbinate bone, the hypertrophic mucosa should also be deal correspondingly so that to benefit the ventilation and drainage of the nasal after operation.