接触式内镜在鼻腔和咽部疾病诊断中的应用

目的探讨接触式内镜在鼻腔及咽部多种疾病中的辅助诊断作用。方法应用接触式内镜观察慢性鼻-鼻窦炎38例,鼻息肉19例,变应性鼻炎15例,慢性鼻咽炎26例,鼻咽癌21例,咽部乳头状瘤5例。结果接触式内镜能够显示鼻腔和鼻咽部不同病变的黏膜微血管及表层细胞的形态分布特点,包括细胞形状、排列、边界、染色情况以及核的大小、核浆比例等。微血管的异常包括不规则扩张、收缩或血栓形成、血管间距拉大、血流缓慢或中断、管壁脆弱易出血等。表层细胞的主要病理改变包括鳞状上皮化生、非典型增生和鳞状细胞癌。结论接触式内镜作为一种新的无创、动态的检查方法,在临床上对鼻腔及咽部的多种疾病具有一定的辅助诊断作用。

Application of contact endoscopy in diagnosing nasal and pharyngeal diseases

Objective To study the value of contact endoscopy in diagnosing nasal and pharyngeal diseases.Methods One hundred and twenty-four cases with nasal and pharyngeal diseases,including chronic rhinosinusitis(38 cases),nasal polyps(19 cases),allergic rhinitis(15 cases),chronic nasopharyngitis(26 cases),nasopharyngeal squamous carcinoma(21 cases) and pharyngeal papilloma(5 cases),were observed through contact endoscope.Results Contact endoscopy allowed observation of the pattern of superficial cells and microvascular network in vivo and in situ in different diseases.The abnormalities of the microvascular network included vascular ectasias or shrinkage,increased space between vessels,thrombosed vessels,fragile vessels and vessels with slow circulation.The abnormalities of superficial cells included squamous epithelium metaplasia,atypical hyperplasia and squamous carcinoma.Conclusion As a kind of new uninvasive method,contact endoscopy is helpful for assistant diagnosis of nasal and pharyngeal diseases.