Morphological changes in the neuroepithelium of the olfactory zone of the nasal cavity in patients with chronic polypous rhinosinusitis

Abstract

Introduction. The polymorphism of clinical manifestations of chronic polypous rhinosinusitis determines the need for a detailed scientific approach in the study of pathogenetic mechanisms.Aim. To study the morphological manifestations of disorders of the neuroepithelium of the olfactory zone of the nasal cavity in patients with chronic polypous rhinosinusitis.Materials and methods. We conducted a prospective analysis of biopsic specimens as well as clinical and functional parameters of 16 patients with chronic polypous rhinosinusitis, who were divided into two groups: treatment group (A) and comparison group (B), aged 25 to 65 years (average age 53 ± 14.3 years). The study subset included 7 men and 9 women. We assessed the main clinical manifestations: radiologic abnormalities in the nasal cavity and paranasal sinuses evaluated according to the Lund-Mackay score, olfactometry and MoCA test in addition to a pathomorphological examination of olfactory neuroepithelium biopsied from the nasal cavity and determination of the chronic inflammation activity index using a histological activity score.Results. In all patients with chronic polypous rhinosinusitis in the symptom complex, there was a violation of the sense of smell in the variants of hyposmia (50%) and anosmia (50%). The presence of neurocognitive disorders according to the MOS test was detected in 70% of patients. During morphological examination, pathological disorders in the olfactory zone of the nasal cavity were caused by atrophy of nerve fibers and lympho-macrophage infiltration involving mixed glands (variable range – mild/moderate/severe). All the analyzed signs were directly dependent on the duration of the disease and the severity of the lesion.Discussion. Analysis of radiologic findings according to the Lund-MacKay score combined with the age of the patients and duration of the disease confirms the rationale of conducted study and its topicality.Conclusion. The revealed pathological changes in the neuroepithelium of the nasal cavity in the olfactory zone were observed only in patients with chronic polypous rhinosinusitis and were directly dependent on the duration of the disease and the form of the inflammatory process.