Olfactory and intranasal trigeminal event-related potentials in anosmic patients

The aim of this study was to investigate the usefulness of chemosensory event–related potentials (CSERPs) in response to both olfactory and intranasal trigeminal stimulation in the diagnosis of anosmia. Forty-four patients participated. Gaseous CO₂ was used for trigeminal stimulation, vanillin and H₂S were used as olfactory stimulants. Event-related potentials to olfactory stimuli could not be obtained in any of the anosmic patients, indicating the complete loss of the sense of smell. However, all patients responded to stimulation of the trigeminal nerve with CO₂. These data clearly demonstrate the clinical significance of CSERPs in the assessment of anosmia.     

Responses to trigeminal irritants at different locations of the human nasal mucosa

BACKGROUND: Previous work suggests differences in the distribution of human intranasal trigeminal receptors. The aim of this study was to investigate these topographic differences for different concentrations of different trigeminal irritants using an electrophysiologic measure of trigeminal activation, the negative mucosa potential (NMP). MATERIALS AND METHODS: A total of 15 healthy volunteers participated. Presented by a computer-controlled olfactometer CO2 (30% and 40% v/v), ethyl acetate (5.5% and 9.3% v/v) and acetic acid (205 and 40% v/v) were used for stimulation. NMP was recorded at the middle septum, the middle turbinate, and the floor of the nasal cavity. RESULTS: Maximum amplitudes of the NMP were found at the middle septum and were lowest at the nasal floor. Response amplitudes were related to stimulus concentrations. There was no significant difference between responses to the three different stimuli in relation to three recording sites. CONCLUSIONS: In agreement with previous work, the present data suggest that there are topographic differences in the responsiveness of the mucosa to chemical irritants.     

Recordings of the optical intrinsic signal from the middle turbinate in response to olfactory and trigeminal stimulation: a pilot study

Responses from the middle turbinate elicited by olfactory and trigeminal stimuli were studied using the intrinsic optical signal (IOS) recording technique. Nasal cavity was illuminated by 617 nm light. Olfactory (H(2)S) or trigeminal (CO(2)) stimuli of 5-s duration were presented using a computer-controlled olfactometer; IOS responses were captured by a special camera. Averages across five individual IOS recordings were analyzed. When the nasal cavity was exposed to H(2)S, a significant change of the IOS was found; responses to CO(2) were even more pronounced. The present results argue for the idea that the IOS is an indicator of intranasal chemosensory activation.     

电刺激蝶腭神经节对鼻粘膜血流的调控作用

为了解蝶腭神经节在鼻粘膜血流调节中的作用，应用激光多普勒血流仪观察刺激蝶腭神经节对猫鼻粘膜血流变化的调控作用。结果表明，电刺激一侧蝶腭神经节可以引起双侧鼻粘膜血管扩张，血流增加，并产生喷嚏反射，这种反应依电刺激的强度、频率而异，且与刺激时间有关。电刺激一侧副交感神经（切除颈上交感神经节的翼管神经）远侧游离端，只引起同侧血管反应。提示刺激蝶腭神经节引起的血管反应可能是通过中枢反射机制起作用。实验还显示刺激蝶腭神经节具有“反向血流调节作用”，这种调节作用的机制有待于进一步研究。     

Immunohistochemical localization of lysozyme in the nasal respiratory mucosa

Summary By use of the indirect immunoperoxidase method, lysozyme was localized in the serous glands and serous parts of mixed mucous-serous glands of the nasal respiratory area. Histochemically, lysozyme was absent from acini containing acid mucosubstances. These findings are in agreement with localizations of lysozyme in glands at other sites.     

吸入糖皮质激素对变应性鼻炎大鼠鼻黏膜病理改变影响的实验研究

目的 探讨吸人性糖皮质激素对变应性鼻炎大鼠鼻黏膜病理改变的影响.方法 选健康SD大鼠180只,应用随机数字表法完全随机分成正常对照组(A组,60只)和实验组(120只).首先对实验组大鼠予以卵清蛋白(ovalbumin,OVA)进行基础致敏、致敏加强、局部激发建立变应性鼻炎动物模型,然后再将实验组动物完全随机分为B、C二组,每组60只.B组继续予以等浓度OVA双侧鼻腔滴鼻,每周2次;C组在予以等浓度OVA双侧鼻腔滴鼻每周2次的同时,每天予以丙酸氟替卡松每侧鼻腔50μl/,次,喷鼻1次,A组则以等量生理盐水代替进行腹腔注射及滴鼻.分别于治疗后第1、2、4、8、12、及16周末从各组中随机挑选10只进行处死,其中1只行鼻黏膜微血管铸型,其余9只立即取鼻黏膜送病理检查,以观察鼻黏膜形态学改变、微血管铸型情况.结果 大鼠接受变应原激发后,鼻黏膜出现柱状上皮杯状细胞化生,部分细胞剥脱,固有层腺体增生肥大、嗜酸粒细胞为主的炎症细胞浸润及血管增多;电镜下见上皮层纤毛不同程度脱落,排列欠整齐,基底膜板层网状结构增厚,胶原沉积及纤维增生,微血管密度增加,血管迂曲,粗细不一,并交织成网状.B组由于持续变应原接触,鼻黏膜病变进一步加重;C组吸入糖皮质激素后可有效控制临床症状,但鼻黏膜仍有纤毛脱落,上皮细胞杯状细胞化生,腺体增生及炎性细胞浸润,基底膜增厚,胶原沉积及纤维增生,微血管密度增加.结论 变应性鼻炎可导致鼻黏膜发生病理改变,接触时间越长,病变越明显.糖皮质激素可较好地控制变应性鼻炎的症状,在一定程度上可减轻鼻黏膜的病理改变,但对已经发生不可逆性改变的黏膜结构无逆转或明显的修复作用.     

Fenestrated endothelia in vessels of the nasal mucosa

Summary The ultrastructure of the vessels in the normal respiratory and olfactory mucosa of the nasal septum was studied in 15 adult rabbits. Capillaries with continuous and fenestrated endothelia could be observed in both tissues. In the respiratory part, many of the fenestrated capillaries were located subepithelially with their fenestrations facing the adjacent epithelium. Fenestrated capillaries of the olfactory mucosa were found mainly in the deeper parts of the tunica propria and usually revealed only a small number of fenestrations in their endothelial lining. It was also demonstrated that muscularized veins sometimes displayed fenestrated areas in their attenuated endothelia. These results are discussed and compared with the appropriate literature. Our results confirm that there is a link between the morphological peculiarities of the vascular wall and the functional behaviour of the nasal mucosa. These findings also emphasize that endothelial fenestrations seem to be characteristic for a certain segment of the microcirculatory system rather than for a distinct type of capillary vessel.     

Healing of the nasal septal mucosa in an experimental rabbit model of mucosal injury

ObjectiveThe aim of this study was to investigate the regeneration process of the nasal mucosa after a surgically created mucosal defect in the rabbit nasal septum, and to evaluate the effects of different interventions.MethodsA 7 mm-diameter circular mucosal defect was made in the septum of forty New Zealand white rabbits. The rabbits were divided into four groups (ten rabbits in each group) according to the type of intervention; no treatment (control), silastic sheet (SS), hyaluronic acid (HA), and silastic sheet and hyaluronic acid (SS + HA) group. The diameter of the defect, mucosal thickness, epithelial thickness, and ciliated cell count were evaluated every week for five weeks.ResultsThe average diameter of the defect in the control group were 5.1, 3.65, 1.2, 0.75, and 0.05 mm at postoperative 1, 2, 3, 4, and 5 weeks. In the SS group, the diameter decreased to 4.35, 2.1, 0.35, 0.15, and 0 mm at postoperative 1, 2, 3, 4, and 5 weeks, respectively, in which the mean diameter of the postoperative week 2 was significantly smaller compared to control (3.65 mm vs. 2.1 mm, P = 0.039). For the HA group and SS + HA group, the diameter of the defect did not show a significant difference from the control group during the five weeks. The mucosal thickness, epithelial thickness, and ciliated cell count of the regenerated mucosa were not significantly different among the groups.ConclusionThe regeneration process of the nasal septal mucosa was identified using a novel rabbit model. Mucosal regeneration can be accelerated by applying silastic sheets.     

影响慢性鼻窦炎鼻息肉患者内镜术后嗅觉改善的因素

目的 :探讨影响慢性鼻窦炎鼻息肉患者内镜术后嗅觉改善的有关因素。方法 :4 4例伴有嗅觉障碍的慢性鼻窦炎鼻息肉患者在内镜手术后半年 ,对其性别、分型分期、病变部位、过敏因素、嗅觉障碍时间、随访等因素进行logistic回归分析。 结果 :分型分期 (病变严重程度 )、过敏、随访等 3个因素对内镜术后嗅觉能否改善有显著影响 (P <0 .0 5 ) ;而性别、病变部位和嗅觉障碍时间则无明显影响 (P >0 .0 5 )。结论 :为了使慢性鼻窦炎鼻息肉患者术后嗅觉功能尽可能地恢复 ,在内镜手术彻底清除病变的基础上 ,积极治疗变应性鼻炎和定期随访是十分重要的     

麻黄碱对鼻黏膜的影响及三磷酸腺苷对其治疗作用的探讨

目的:观察麻黄碱对健康Sprague-Dawley大鼠鼻黏膜形态、超微结构的影响,并探讨三磷酸腺苷(ATP)对它的干预作用。方法:健康Sprague-Dawley大鼠23只采用随机数字表法分为3组:对照组(A组),麻黄碱滴鼻组(B组),麻黄碱滴鼻加ATP腹腔注射组(C组)。于1、2、3、8周取鼻黏膜进行光镜和电镜观察。结果:B组用药第1、2、3周鼻黏膜的损害逐渐加重,3周后停药,第8周取材,观察损伤鼻黏膜形态没有恢复正常。C组用药第1周鼻黏膜几乎没有损伤,第2、3周鼻黏膜稍有损伤,3周后停用麻黄碱并续用ATP至第8周见损害鼻黏膜形态基本恢复正常。结论:麻黄碱可损伤健康Sprague-Dawley大鼠鼻黏膜,并随时间推迟而损伤程度加重,且损伤达到一定程度不可恢复;ATP可减轻麻黄碱对Sprague-Dawley大鼠鼻黏膜的损害,对麻黄碱引起的鼻黏膜损伤具有保护和治疗作用。     

豚鼠鼻黏膜表面活性物质板层体的透射电镜观察

目的 观察鼻黏膜表面活性物质板层体的超微结构。方法 取正常豚鼠鼻中隔黏膜行透射电镜观察。结果 鼻中隔黏膜内存在板层体,为圆形、层状或线圈 状小体,致密,散在。结论 鼻黏膜存在板层体,其分泌的表面活性物质在鼻功能和病理生理学中起作用。     

鼻咽癌放疗后鼻黏膜组织形态学的研究

目的:研究放疗对鼻咽癌患者鼻黏膜组织形态学的影响.方法:按患者纳入条件和剔除条件选择鼻咽癌患者47例,于放疗前后各取中鼻甲黏膜组织1块,采用常规苏木精-伊红染色及PAS染色,光镜下观察鼻咽癌放疗前后中鼻甲黏膜之上皮层的纤毛和细胞、基底层及固有层的腺体和腺细胞的改变;同时随机抽取6例用扫描电镜和透射电镜观察其上皮层的纤毛及纤毛柱状上皮细胞的变化.结果:放疗前,47例患者鼻黏膜组织形态均正常;放疗后,6例无明显变化,41例出现不同层次和不同程度改变.光学显微镜下见:上皮细胞及纤毛脱落,基底膜增厚,固有层的浆液腺减少,黏液腺增多,血管扩张、充血、增生,血管内皮细胞损伤等;扫描电镜下见:纤毛结构异常,出现脱落、粘连成簇状等现象;透射电镜下见:上皮细胞的细胞核形态不规则、固缩,细胞质出现空泡,细胞器明显减少等.结论:鼻咽癌放疗后鼻黏膜组织形态受到不同程度破坏,这可能是鼻咽癌放疗后并发鼻及鼻窦炎的病理学基础.     

白细胞介素-12在变应性鼻炎鼻粘膜中的表达

目的 :探讨白细胞介素 12 (IL 12 )在变应性鼻炎鼻粘膜中的表达。方法 :以卵清蛋白为变应原建立豚鼠变应性鼻炎模型 (模型组 )。取该模型和健康豚鼠鼻粘膜行常规HE染色 (对照组 ) ,并采用逆转录 聚合酶链反应 (RT PCR)检测方法 ,对两组动物鼻粘膜组织中IL 12mRNA表达水平进行相对定量比较。结果 :IL 12mR NA在两组鼻粘膜中均有表达 ,模型组的表达水平为 0 .6 6 7± 0 .10 4显著低于正常对照组 0 .84 7± 0 .0 71(P <0 .0 1)。结论 :在变应性鼻炎鼻粘膜组织中IL 12的表达下降 ,提示应用IL 12替代疗法治疗变应性鼻炎的可能性。     

变应性鼻炎鼻黏膜结构变化及微血管重塑实验研究

目的探讨持续暴露变应原大鼠鼻黏膜结构及微血管的改变。方法60只SD大鼠随机分为正常对照组（A组）和持续暴露变应原组（B组）以卵清白蛋白激发法制备变应性鼻炎（allergic rhinitis,AR）模型,每组大鼠各半,采用鼻黏膜组织HE染色法和鼻黏膜微血管铸型方法分别观察8、12、16周鼻黏膜组织病理学特征和微血管形态学改变。结果与A组相比,B组大鼠的鼻黏膜变应原暴露8周后表现为黏膜上皮大量脱落,杯状细胞化生明显,腺体分泌旺盛;微血管铸形观察可见微血管扩张、通透性增加明显,行经迂曲。12,16周表现为上皮细胞剥脱明显,上皮下纤维化,杯状细胞化生减少,血管增生,血管内皮细胞轻度肿胀,毛细血管增生明显,管腔内壁不规则,管壁纤维化、增厚;微血管铸型观察可见血管内皮细胞肿胀甚至萎缩,管腔内壁不规则,管壁纤维化,毛细血管增生明显。结论AR鼻黏膜早期炎性损伤、后期黏膜组织增生和纤维修复及微循环血管重塑是持续暴露变应原AR大鼠鼻黏膜的组织病理学基础。     

Ruthenium red antagonism of capsaicin-induced vascular changes in the rat nasal mucosa

Mechanisms of capsaicin-induced vascular changes were examined in the nasal mucosa of anesthetized adult rats. Intra-arterial infusions of capsaicin at doses of 20–100 pmol/min into the external carotid artery resulted in a dose-dependent increase in nasal blood flow as assessed by laser-Doppler flowmetry. Intra-arterial infusion of ruthenium red (RR, 2.5–10 µmol) prior to the administration of capsaicin significantly inhibited the capsaicin-evoked response. The technique of vascular labelling was used to examine nasal mucosal vascular permeability. Intravenous administration of colloidal silver solution prior to capsaicin infusion resulted in accumulation of colloid in the walls of small blood vessels, indicative of enhanced vascular permeability. Vascular labelling was largely abolished after RR pretreatment. These findings suggest that neuropeptides released from trigeminal sensory nerve endings play a significant role in the local vascular and inflammatory reactions of the nasal mucosa. The experimental approach utilized in this study provides a promising model for defining the roles of capsaicin-sensitive afferent nerves in the mechanisms of allergic and/or inflammatory diseases affecting the nasal mucosa.     

Distribution of nitric oxide in the nasal mucosa of the rat: A histochemical study

We evaluated the distribution of nitric oxide (NO) in the rat nasal mucosa using nicotineamide adenosine dinucleotide phosphate (NADPH)-diaphorase histochemistry. The NADPH-diaphorase positive nerve fibers in the nasal mucosa were observed around blood vessels and submucosal glands and in sphenopalatine ganglions. Strong positive reactions for NADPH-diaphorase were observed in ganglions as compared with the other tissues. In septal and turbinate mucosa, positive reactions for NADPH-diaphorase were mainly seen in the anterior portion, and a few positive reactions were observed in the posterior portion. No positive reactions for NADPH-diaphorase were demonstrated in the sinus mucosa. These results suggest that NO may be related to regulation of blood flow, glandular secretion and neurotransmission, and also that NO may play an important role in the defence mechanism of the upper airway system against external environments.     

Ciliated mucous cells found in the nasal mucosa of a patient with Kartagener's syndrome

Summary Transmission electron microscopy revealed the presence of ciliated cells containing many mucous secretory granules in the nasal surface epithelium of a 13-year-old patient suffering from Kartagener's syndrome. In these cells, mucous secretory granules were accumulated in the apical cytoplasm, and the Golgi apparatus was well developed in the supranuclear region. Mucous secretory granules were discharged infrequently through the apical cell membranes by single or compound exocytosis. The cells were considered to be ciliated mucous cells, which have already been reported to be present in the lower respiratory tract but not in the upper respiratory tract.     

症状、CT和鼻声反射在慢性鼻窦炎组织重构诊断中的意义

目的探讨鼻塞症状、CT扫描Lund-Mackay评分和鼻声反射测量鼻黏膜充血指数与慢性鼻及鼻窦炎(chronic rhinosinusitis,CRS)组织重构程度之间的相关性,探讨三者在CRS组织重构诊断中的意义。方法选取CRS患者43例,应用视觉模拟评分(visual analogous scale,VAS)系统评价鼻塞症状;Lund- Mackay平分系统评价鼻窦CT扫描结果;鼻声反射测量获取鼻黏膜充血指数;钩突黏膜组织标本行鼻黏膜纤维化程度评分。应用统计学方法对其相关性进行分析。结果鼻塞症状严重程度与鼻黏膜纤维化程度之间无明显相关性(r=-0.046,P=0.77);CT评分与黏膜组织纤维化评分之间无相关性(r=0.132,P=0.40);鼻黏膜纤维化程度与鼻黏膜充血指数之间呈负相关(r=-0.348, P=0.022)。结论鼻黏膜充血指数能够反映病变黏膜的组织重构程度,辅助症状与CT检查指导CRS治疗策略。