CC BY
24
State of reticular fibers in various forms of polypoid rhinosinusitis
3. Mukhin K.Y, Petruhin A.S, Glukhov L. Y., Epilepsy. Atlas of EEG diagnostics. M.: Publishing Alvarez in 2004.
4. Halasz P, Are Absence Epilepsy and Nocturnal Frontal Lobe Epilepsy System Epilepsies of the Sleep/Wake System?, Behavioural Neurology, vol. 2015. P. 1-15, 2015.
5. Degerliyurt A, Yalnizoglu D, Bakar E, Topcu M, and Turanli G, "Electrical status epilepticus during sleep: A study of 22 patients," Brain & Development, vol. 37, no. 2. P. 250-264, 2015.
6. Koessler L., Cecchin T., Colnat-Coulbois S., Vignal J., Jonas J., Vespignani H., Ramantani G., and Maillard L., Catching the Invisible: Mesial Temporal Source Contribution to Simultaneous EEG and SEEG Recordings, Brain Topography, vol. 28, no. 1. P. 5-20, 2015.
7. Baslet G., Barbara D., Perez D. L., Oser M., "Treatment of Psychogenic Nonepileptic Seizures: Updated Review and Findings From a Mindfulness-Based Intervention Case Series," Clinical EEG And Neuroscience, vol. 46, no. 1. P. 54-64, 2015.
Vokhidov Ulugbek Nuridinovich, Tashkent Medical Academy Department of ENT diseases with course of stomatology
E-mail: [email protected]
State of reticular fibers in various forms of polypoid rhinosinusitis
Abstract: Nasal polyposis is a condition which brings physicians more questions than answers. We studied 45 patients with chronic polypoid rhinosinusitis in 2013, whom we performed surgery, followed by morphological and immunohistochemical studies of macropreparations. All types of polypoid tissue had been divided into "eosinophilic" and "neutrophilic" forms. The study showed that "eosinophilic" polypoid rhinosinusitis had greater swelling and degradation of reticular fibers in comparison with the "neutrophil" polypoid rhinosinusitis.
Keywords: chronic polypoid rhinosinusitis, morphological study, immunohistochemical study, reticular fibers.
Chronic polypoid rhinosinusitis (CPRS) — a chronic inflammatory disease of the mucous membrane of the nasal cavity and paranasal sinuses characterized by the formation and growth of recurrent polyps, consisting mainly of edematous tissue infiltrated by eosinophils and neutrophils [1; 2; 3].
Traditionally nasal epithelium considered as a passive barrier, covering the nasal cavity, which protects tissues from various pathogens and allergens [4]. At the same time gradually accumulated evidence that the epithelium — an active participant in the immunological response. In nasal polyposis, it conducts like an active participant in the pathogenesis and as a passive target in pathological processes [4; 6]. The basic structure of stroma of nasal polyps consists of connective reticular fibers. Reticular fibers (diameter 0.5-2 mm) is a product of the synthesis of reticular cells. They are found in the impregnation salts of silver, so called argyrophilic. These fibers are resistant to weak acids and bases and digested with trypsin [5; 6]. Actually reticular fibers are final formation, containing collagen type III. Reticular fibers mucosa provides elasticity of the mucous membrane of the nose and paranasal sinuses. By extensibility, these fibers are intermediate between collagen and elastic tissue [6].
Many authors give a leading role in the development of CPRS to eosinophils infiltrating the stroma polyp [1; 2], not taking into account the type of histological structure of other optional stromal cells, which infiltrated polypous-altered mucosa. Depending on the infiltration of the stroma of the mucous membrane polyps are divided into "infectious" (neutro-philic) and "allergic" (eosinophilic) [7]. This fact is justified
on the predominance of eosinophils during allergic inflammation and neutrophil — with non-allergic inflammation [7].
Based on the above, the aim of our study was to investigate the reticular fibers in various forms of chronic polypoid rhinosinusitis.
Material and methods. The material of this study were paraffin sections of surgical specimens, removed during endoscopic surgery of the nose and paranasal sinuses in 45 patients aged 18-77 years who were hospitalized to the ENT department of 3-rd clinic of the Tashkent Medical Academy (32 men and 13 women) in 2013. Morphological and immunohistochemical studies were conducted on paraffin-embedded surgical material with thickness of 3 mm. The morphological study was consists of painting by hematoxylin-eosin. With the help of morphometry we revealed polypoid forms by determining the prevalence of eosinophil and neutrophil infiltration. The immunohistochemistry with impregnation by silver staining was carried out with at Gordon-Suite method for determining the reticular fibers of the stroma of the nasal polyps. The results of the survey were evaluated with magnification of 40*10 on the light microscope. Statistical analyses were carried out on the Microsoft Excel 2010.
Results. Morphologic study of the mucous membrane of polyps in patients with CPRS stated the desquamation of ciliated epithelium, edema of the lamina propria, which was heavily infiltrated by eosinophils and neutrophils, plasma, goblet cells, blood vessels.
The morphological symmetry of postoperative material of 33 cases (73,3%) stated the prevalence of eosinophilic in-
Section 7. Medical science
filtration of the stroma of the mucous membranes of the nose and paranasal sinuses, 12 cases (26,7%) noted the predominance of neutrophilic infiltration of the stroma of the mucous
membranes of the nose and paranasal sinuses (Fig.1,2). In this regard, the patients were divided into two groups: patients with "eosinophilic" and "neutrophilic" rhinosinusitis.
Fig. 1. The magnification of x 200. Nasal polyps. Morphologic study determined the prevalence of neutrophilic infiltration of the stroma of the mucous membranes of the nose
Fig. 2. The magnification of x 200. Nasal polyps. Morphologic study determined the prevalence of eosinophilic infiltration of the stroma of the mucous membranes of the nose
Fig. 3 (a, b). The magnification of x 200. Fig. 4 (a, b). The magnification of x 200.
Painting polyps on Gordon's method in patients Painting polyps on Gordon's method in patients
with "eosinophilic" polypoid rhinosinusitis with "neutrophilic" polypoid rhinosinusitis
