The observation of the ostiomeatal complex mucosal pathological morphology in chronic rhinosinusitis

Objective To observe the histopathology and ultra-microstructure change and differenced of the ostiomeatal complex (OMC) mucosa in chronic rhinosinusitis (CRS). Methods Patients needed endoscopic sinus surgery (ESS) in my department were divided into three groups (the mixed, allergy and infection). The allergy, infection and control groups were observed by light microscope. Twenty patients were in each group. The thickness of basement membrane and the area of mucous glands of the three groups were measured. Five patients were randomly selected from each group and were observed by scanelectron microscope (SEM). Results The mucosa of healthy controls was smooth and glossy, dominated by ciliated cells mostly. The cilia was neat and erect, the basement membrane was thin, the the interstitial substance was non -edematousus, and no increase in the number of inflammatory cells. Various changes in the OMC mucosa of the patients group could be observed, including increase of the goblet cells, thickening of the basement membrane, infiltration of inflammatory cells, the hyperplasia of mucous glands and the epithelial fiber tissue. These changes in the allergy group were more evident than those in the infection group. Under VG staining, the thickness of the basement membrane was (8.574±0.624) μm in the control group, (14.552±0.641) μm in the allergy group, and (12.561 ±0.493) μm in the infection group. Under AB -PAS staining ,the area of the mucous glands was (0.082 ± 0.006) mm 2 in the control group, (0.184±0.007) mm 2 in the allergy group, and (0.137±0.005) mm 2 in the infection group. The difference between the three groups was significant (P 0.05). Under SEM, the cilia in the controls was well-distributed, neat and aligned in the same direction. The epithelium of the patient group had different pathological characteristics. The cilia in the allergy group was disordered, lodging, clustered and adhered to a large volume of mucus. But in the infection group, we observed the large area of desquamation of cilia and replacement by micro -villi and micro-cilia. Conclusions By observing the histopathology and ultra-microstructure, different presentations can be observed in different types CRS. For this reason, the classification of CRS based on the etiopathogenisis may be valuable for the diagnosis and treatment of CRS.