Histological And Cytological Observation Of The Self-adaptation Of Inferior Turbinate Mucosa In Patients With Abnormal Anatomy Of Nasal Cavity

OBJECTIVE:According to the three-dimensional reconstruction of nasal cavity by airway surface rendering and the numerical simulation of airflow field and temperature field in the nasal cavity, observe and compare the histological structure of nasal mucosa on the bilateral inferior turbinates in patients with C-type deviated nasal septum and hypertrophic inferior turbinate, investigate the effects of temperature in the nasal airway on proliferation and collagen excretion of human inferior turbinate fibroblasts in vitro. To primarily explore the self-adaptation of structure and function of nasal cavity, and to provide reference for the treatments of nasal diseases related to abnormal anatomy.METHODS:1. Histological observation:15mucosa samples of front inferior turbinate were taken in the surgeries of the nasal septum and turbinates. These samples were made into pathological sections and studied under optical microscope. Taking photographs of the lamina propria by OLYMPUS microscope at400X to pick visual fields randomly and count the morphologically significant fiber cells and fibroblasts.2.Cytological observation:Human inferior turbinate fibroblasts were isolated and cultured at different temperatures in vitro. Proliferation of the fibroblasts was measured by cell counting kit-8assay (CCK-8), Collagen-Ⅲ in the conditioned media was measured by enzyme-linked immunosorbent assay (ELISA).RESULTS:1. Histological observation:Part of mucosa had epithelial degeneration on the bilateral inferior turbinates in patients with nasal septum deviation. Compared with the inferior turbinate in the narrow side of deviation, the one in the opposite side had histological characteristics:goblet cells hyperplasia, incrassation of basement membrane, excessive proliferation of fibroblasts and obvious hyperplasia of fiber structure, hyperplasia and dilation of blood vessels in lamina propria. In visual fields of the same size, the sum of fiber cells and fibroblasts had no significant difference between the bilateral inferior turbinates (P>0.1), but inferior turbinate fibroblasts in the wide side of deviation were obviously more than ones in the narrow side (P<0.01).2.Cytological observation:The drop in temperature (<36℃) decreased the proliferation of fibroblasts and inhibited the synthesis of collagen-Ⅲ with the extension of time. The proliferation of fibroblasts at34℃began to decreased at48h (48h P<0.05,96h P<0.01), compared with the control group at37℃. The proliferation of fibroblasts at32℃had decreased in24h (24h P<0.05,48h P<0.01), compared with the control group at37℃. Collagen-Ⅲ in the conditioned media at34℃and32℃had both reduced at144h (P<0.01), and it was reduced more at32℃.CONCLUSION:1. Abnormal anatomy of the nasal cavity has a physiological procedure of self-adaptation. Histological observation suggests that one of the main performances of the inferior turbinate mucosa is excessive proliferation of fibroblasts and hyperplasia of fiber structure.2. We consider that the change of temperature triggers the self-adaptation. Temperature can affects the proliferation of fibroblasts and the synthesis of collagen-Ⅲ.3. Surgery of the nasal cavity requires quantization of resection and ablation for the improvement of nasal function, abandoning the traditional blind rhinoplasty.4. During self-adaptation, hyperplasia of fiber structure on the inferior turbinate reduce the elasticity of the nasal mucosa, increase the nasal airway resistance, and impede the physiological turbinal cycle. This study would put forward new ideas to clinical treatments.