The Effect To Nasal Mucociliary Clearance System By Partial Inferior Turbinectomy With HUMMER Or Microwave

ObjectiveOur paper was designed to explore the differences of partial inferior turbi-nectomy with HUMMER or microwave which made effect to nasal mucociliary clearance system. Through this study we can offer the theoretical foundation to choose rational operation way for clinical.MethodsTwo groups were selected from patients who were treated in otolaryngology department in the first affiliated hospital of China medical university from 4, 2004 to 6,2004. There were 10 patients in each group. HUMMER was used in the first group and microwave in the second. Ten patients who had no nasal disease were selected as healthy contrast. Every case was drew nasal mucous membrane of inferior turbinate preoperatively, three months and six months after surgery. Two of healthy cases were drew randomly. Light microscope, scanning e-lectron microscope and transmission electron microscope were used to observe material. Every case accepted saccharin test before being drew. All data had been processed with paired sample t - test and analysis of variance.Results1. Saccharin test: MTR of patients was (3. 63 ±0.57)mm/min on average before surgery of partial inferior turbinectomy with HUMMER , which was signifi-cantly different from the one of healthy controls(6. 20 ±0. 68) mm/min ( P <0. 01). There was no significant difference between MTR for three months(3.76 ± 0.43mm/min) after surgery and that before surgery (P >0. 05). MTR for six months after surgery (6. 09 ± 1. 19mm/min) significantly increased compared with that before surgery and three months after surgery (P <0. 01). MTR of patients was (3. 82 ±0. 40) mm/min on average before surgery of partial inferior turbinectomy with microwave , which was significantly different from the one of healthy controls(P <0. 01). There was no significant difference between MTR for three months(3. 96 ±0. 40mm/min) after surgery and that before surgery(P >0.05). There was no significant difference between MTR for six months(3. 95 ±0. 32mm/min) after surgery and that before surgery and three months after surgery (P >0. 05) . MTR for three months and six months after surgery significantly increased comparing with that of healthy controls ( P <0.01) . There was no significant difference between MTR for before surgery and three months after surgery with microwave and that with HUMMER ( P > 0. 05 ). MTR for six months after surgery with microwave significantly increased compared with that with HUMMER (P<0.01).2. Light microscope and electron microscope observed : We could found that goblet cells increased in nasal mucous membrane epithelia before surgery. The change of cilia includes lodging, fracture, disorder, deletion and confluence. Thickness and size of cilia was not coincident. Partial nasal mucous membrane epithelial metaplased from pserdostratified ciliated columnar epithelium to simple cuboidal epithelium before surgery. Nasal mucous membrane epithelia regenerated to pseudostratified ciliated columnar epithelium after surgery with HUMMER. Goblet cells obviously reduced comparing with that before surgery. The cilia changes observed include plent, intensive, coincident direction, clear "9 +2"microtubular structure ,which mainly coincided with normal nasal muco-ciliary system. Nasal mucociliary epithelia regenerated scarely after surgery with microwave. There were squamose epithelial metaplasia on nasal mucous and serious deletion of cilia and confluent "9 +2" microtubular structure.