Histopathological Study on the Lateral Wall of the Inferior Meatus

Abstract

The bony lateral wall of the inferior nasal meatus was studied in 40 cases (45 sides) of chronic sinusitis. The specimen, containing three layers in to-to (nasal mucosa , bony wall and mucosa of the maxillary sinus) was obtained during the Caldwell-Luc operation for the maxillary sinus. The specimen was fixed and stained by H-E method, and each section as a whole was examined under microscope and photocopies were taken using Nikon MacroMultiphoto microscope under the magnification of six times. A photocopy for each section was enlarged to the cabinet size and this enlarged photocopy was used for the final analysis.The characteristic finding of the present study was the irregular cleft-formation in the bony wall. Using the cabinet-sized photocopy, the area for the clefts and the area for the compact bone were measured.The corresponding area was separated from the photocopy and the weight was measured using a Metrer automatic balance up to 10 mg as the minimal unit. The area for the clefts versus the area for the compact bone was expressed in per cent using the weights thus obtained. In 37 sides out of 45, the cleft-formation was found with the average per cent of 8.63 (standard deviation 7.53).As a control study, the anterior wall of the maxillary sinus was also similarly evaluated.The anterior wall of all specimens of the present study did not show any cleft-formation. The percentage of the cleft-area did not show statistically significant differences as regards to the age, sex, years after onset, the degree of sinus wall changes and the presence of allergy detected by skin tests. The irregular spaces occupied by the clefts were filled with dense connective tissue with minimal inflammatory reactions. The nasal surface of the bony wall appeared resorptive and the sinus surface was depository according to Enlow's classification. It was concluded that the lateral nasal wall shows the characteristically developping patterns of resorptive and depository surfaces as a part of the facial growth, and that the bony wall is ordinarily provided with irregular clefts filled with connective tissues. The cleft itself is more of a physiological origin than of an inflammatory. The presence of clefts in 82. 2 per cent of cases suggests a rather free communication between the nasal cavity and the maxillary sinus.