鼻窦黏液囊肿造袋术的组织病理学基础

目的探讨鼻窦黏液囊肿造袋术的组织病理学基础，为鼻窦黏液囊肿造袋术提供理论依据，并观察造袋术的临床疗效。方法21例鼻窦黏液囊肿病人均行经鼻内镜囊肿造袋术，手术后标本作常规病理检查和电镜超微结构检查。随访6～12个月。结果常规病理检查21例均为黏液囊肿，电镜检查除1例为立方状上皮外，其余内衬上皮为假复层纤毛柱状上皮。上皮纤毛发达，线粒体丰富，内质网、高尔基氏体发达，黏液性腺细胞和杯状细胞浆中有大量黏液分泌颗粒，基底膜下有大量淋巴细胞、中性粒细胞及少量嗜酸性粒细胞浸润。术后无1例复发。结论囊肿造袋术是治疗鼻窦黏液囊肿的有效术式。鼻窦黏液囊肿内衬上皮与鼻腔大部分黏膜一样均为假复层纤毛柱状上皮，纤毛发达，术后纤毛功能可以恢复，这是鼻窦黏液囊肿造袋术的组织病理学基础。

The histopathological base of marsupialization about mucocele of nasal sinus

Objective To study the effect and the histopathological base of marsupialization on mucocele of nasal sinus and to provide theory for marsupialization. Methods Marsupialization was chosen for 21 cases of mucolece of nasal sinuses under endoscope.After the operation the sample received pathological examination under electron microscope and light microscope. The follow up time was from 6 months to 12 months. Results The epithelia of 20 cases were pseudostratified ciliated columnar epithelium. The cilium was prosperous, the mitochondrion was rich, and the endoplasmic reticulum and the Golgi complex were developed. There were a lot of secretory granule in goblet cell and mucous glandular cell; there were many lymphocytic cells, neutrophilic granulocytes, and a small quantity of eosinophilic granulocytes. No case recurred. Conclusion Marsupialization is an effective operation to treat mucocele of nasal sinus. The epithelium of both mucocele and nasal mucosa is the same pseudostratified ciliated columnar epithelium. Rich cilium in mucocele and the function of cilium could be recovered, as the base of marsupialization about mucolece of nasal sinus in histopathology.