The Inferior Turbinate Mast Cell Population of Patients with Perennial Allergic and Nonallergic Rhinitis

Berger, Gilead; Goldberg, Arnon; Ophir, Dov

doi:10.2500/105065897781446775

Cited by 39 publications

(35 citation statements)

References 14 publications

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“…Two previously reported studies from our group did not disclose significant differences in the population of mast cells and goblet cells between allergic and nonallergic patients. 27,28 On the other hand, Schmidt et al 17 conducted a quantitative and qualitative assessment on fibrosis, edema, and blood vessels and reported different findings between the two. Possible differences between the dimensions of the IT in patients with perennial allergic and vasomotor rhinitis warrant further clarification.…”

Section: Commentmentioning

confidence: 99%

The Histopathology of the Hypertrophic Inferior Turbinate

Berger¹,

Gass²,

Ophir³

2006

Arch Otolaryngol Head Neck Surg

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103

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Subjects: Seventeen patients with refractory IT hypertrophy and 12 with normal ITs.Interventions: Twenty ITs were removed from patients with refractory IT hypertrophy and 14 from patients with normal ITs. Main Outcome Measures:The soft tissue and bony elements and the relative proportions of the soft tissue constituents of the hypertrophic and normal ITs were measured and compared. The Bonferroni correction was used to adjust for multiple comparisons. Qualitative assessment was performed to assess possible pathologic changes in all IT tissues.Results: The hypertrophic ITs were significantly wider. The medial mucosal layer, which thickened from a mean ± SD of 1.39±0.28 mm to 2.53±0.56 mm (PՅ.001), made the greatest contribution to the total increase in the width of the IT (64.4%). The enlargement in width of the lateral mucosal layer from 0.91±0.26 mm to 1.26±031 mm was of borderline statistical significance. The portion of the medial, lateral, and inferior layers of the lamina propria that houses inflammatory cells enlarged significantly in patients with IT hypertrophy compared with healthy control subjects. The relative proportion of the connective tissue, submucosal glands, and arteries remained unchanged, whereas that of venous sinusoids increased significantly in all aspects of the hypertrophic mucosa. Fibrosis, inflammation, and engorged venous sinusoids were noted in hypertrophic ITs, yet there was no evidence of tissue destruction. Conclusion:Understanding the histopathology of the hypertrophic IT is imperative for the development and management of IT reduction surgery.

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Section: Commentmentioning

confidence: 99%

The Histopathology of the Hypertrophic Inferior Turbinate

Berger¹,

Gass²,

Ophir³

2006

Arch Otolaryngol Head Neck Surg

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103

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“…16,17 As mentioned earlier, patients with PNAR had an extent of epithelial shedding similar to that of controls but significantly less pronounced than that in patients with allergy. Others report the phenomenon in detail and found that (similar to patients with PAR outside of the pollen season) the BM of patients with PNAR displayed a significantly greater extent of epithelial denudation compared with controls but showed a lesser extent of denudation compared with patients with PAR during the pollen season.…”

Section: Commentmentioning

confidence: 75%

Epithelial Shedding of the Inferior Turbinate in Perennial Allergic and Nonallergic Rhinitis

Berger

Bernheim²,

Ophir³

2007

Arch Otolaryngol Head Neck Surg

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Setting: University-affiliated hospital.Patients: Fifty-eight inferior turbinate samples were processed for histological study. Nineteen were from patients with PAR, and 20 were from patients with PNAR. Samples from 19 healthy individuals who underwent rhinoplasty for cosmetic reasons served as control specimens. Main Outcome Measures:The length of the basement membrane (BM) covered with intact epithelium, covered with a single layer of basal cells, and devoid of epithelium was measured.Results: Intact respiratory epithelium and areas of partial and complete epithelial denudation were encountered in control specimens and in samples from patients with PAR and PNAR. A significant difference was found between the 3 groups (P=.001). The proportion of the BM covered with undamaged epithelium was significantly greater in control specimens and in samples from patients with PNAR than in samples from patients with PAR; the difference between the former 2 groups was nonsignificant. Most of the epithelial damage in patients with PAR occurred between columnar and basal cells rather than between basal cells and the BM (P=.02).Conclusions: Epithelial shedding of the inferior turbinate is a genuine feature of PAR and is not an artifact of tissue sampling. The finding of greater epithelial exfoliation between basal cells and the more superficial columnar cells than between basal cells and the BM probably reflects different attachment qualities of these cells.

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“…Some researchers believe overactive parasympathetic nerve discharge could lead to vasodilatation of submucosal venous sinusoids, resulting in congestion and excess seromucus production [7,8]. Recent work with capsaicin has shown that local neural defects such as altered nociceptor function may also play a role in nonallergic rhinitis [2,9].…”

Section: Pathophysiologymentioning

confidence: 99%

Nonallergic rhinitis in children

Berger¹,

Schönfeld²

2007

Curr Allergy Asthma Rep

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Nonallergic rhinitis in children is a medical condition that has not been well defined and the true incidence is unknown. Current treatment recommendations are based on data obtained from adult studies. The mechanisms of pediatric nonallergic rhinitis are also unclear. The concept that laryngopharyngeal reflux (LPR) events may play a critical role in the pathogenesis of upper airway disease is presently under investigation. Although LPR is being better delineated and appropriate methods of diagnosis and treatment are being studied, substantial evidence links LPR with several disease states including rhinitis, sinus disease, and middle ear disease. Due to the lack of information concerning the etiology of nonallergic rhinitis in children, LPR should be considered in the differential diagnosis of a child with negative skin tests and chronic rhinitis symptoms. The clinician should especially give attention to this diagnosis when a child presents with recurrent co-morbid conditions such as chronic sinusitis or persistent middle ear disease.

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The Inferior Turbinate Mast Cell Population of Patients with Perennial Allergic and Nonallergic Rhinitis

Cited by 39 publications

References 14 publications

The Histopathology of the Hypertrophic Inferior Turbinate

The Histopathology of the Hypertrophic Inferior Turbinate

Epithelial Shedding of the Inferior Turbinate in Perennial Allergic and Nonallergic Rhinitis

Nonallergic rhinitis in children

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