Морфометрична характеристика структурних елементів слизової оболонки лобової пазухи людини в нормі та при хронічному фронтиті

Abstract

Проведене морфометричне дослідження структурних елементів слизової оболонки лобової пазухи людини в нормі та при хронічному фронтиті. Матеріалом були слизові оболонки, отримані від трупів людей,що померли з причин, не пов’язаних з патологією при носових пазух та біопсійний матеріал, отриманий при операціях на лобовій пазусі. Було встановлено, що при хронічному фронтиті у порівнянні з контрольною групою морфометрично встановлено, що у відповідь на хронічний запальних процес відбувається судинна реакція, яка проявлялась спастичними капілярними реакціями і дилятаційними реакціями з боку артеріол та венул. Залози при хронічному фронтиті реагували зменшеною активністю білкових залоз і підвищеною активністю змішаних залоз які виробляють мукоїдний компонент секрету. На гістологічних препаратах епітеліоцити кінцевих відділів змінювали щільність цитоплазми, а у протоковій системі візуалізувалась велика кількість слизу. Паралельно з цим спостерігалось нерівномірне кровонаповнення елементів гемомікроциркуляторного русла і спостерігались діапедезні крововиливи.

Резюме. Проведено морфометрическое исследование структурных элементов слизистой оболочки лобной пазухи человека в норме и при хроническом фронтите. Материалом были слизистые оболочки, полученные от трупов людей, умерших по причинам, не связанным с патологией приносовых пазух и биопсийный материал, полученный при операциях на лобной пазухе. Было установлено, что при хроническом фронтите по сравнению с контрольной группой происходит сосудистая реакция, которая проявлялась спастическими капиллярными и дилатационными реакциями со стороны артериол и венул. Железы при хроническом фронтите реагировали уменьшенной активностью белковых желез и повышенной активностью смешанных желез производящих мукоидный секрет. На гистологических препаратах эпителиоциты конечных отделов меняли плотность цитоплазмы, а в протоковой системе визуализировалось большое количество слизи. Параллельно с этим наблюдалось неравномерное кровенаполнение элементов гемомикроциркуляторного русла и наблюдались диапедезные кровоизлияния.

Abstract. Chronic inflammatory processes of the nasal mucous membrane and paranasal sinuses are the most common diseases of the upper respiratory airway, which have beeng increasing in absolute figures, as well as in percentage of total ENT pathology. The aim of research is to analyze the changes in metric indices of structural elements of human frontal sinus in norm and in case of chronic frontitis. Object and methods of research. Mucous membrane of 10 frontal sinuses of people aged from 22 to 86 years both sexes, who died from causes which were not associated with paranasal sinus pathology according to international standards for biological research, were investigation material for the study as well as 7 biopsy specimens obtained while performing surgical intervention on affected frontal sinus. Material was fixed in 10% neutral formalin, paraffin blocks were prepared after classical processing, fragments of the mucous membrane of frontal sinus were oriented so, that the cut passed through all the layers. Histological sections with a thickness of 4-5 |jm were made and stained with hematoxylin and eosin as well as Mayer’s hematoxylin. Morphometric studies were carried out using a microscope with digital photomicrographic attachment Olympus C 3040-ADU with the programs adapted for presented studies. When comparing the morphometric parameters of the average diameter in hemomicrocirculatory bloodflow of periacinar microvessels around protein and mixed acini, it was determined that these values approximated each other and significant difference at p <0.05 was not observed. This indicates that periacinar microvessels have almost the same (within the limits of error tolerance) average size and histologically classical structure, which should be considered when analyzing such indicators in chronic frontitis. Vascular response is a classical sign of the inflammatory process.Thus, in chronic frontitis, the elements of hemomicrocirculatory bloodflow responded differently. The average diameter of periacinar arterioles of both protein and mixed end parts was significantly increased by an average of 1.6 times at p <0.05. This indicates that the flow of blood to the end parts which directly produce serous and mucoid secret is increased. The average diameter of protein and mixed acini capillaries was significantly decreased by 1.2 times at p <0.05, which indicated their spasms, and resulted in difficulty of blood transfer from arterial to venous bloodflow. The average venule size was also significantly increased at p <0.05 almost by1.4 times, in comparison with the control parameters. Such vascular response indicates that blood circulation in mucous membrane of the frontal sinus is complicated by spastic capillary responses and dilatation responses from arterioles and venules. Along with the vascular response to chronic inflammatory process, changes in the glandular component of mucous membrane of human frontal sinus occured. Thus, the height of epitheliocytes in protein acini decreased by 12% compared to the control group at p <0.05, and in mixed acini, on the contrary, it increased by 24%, indicating the changes in secretion profile toward mucoid. The external diameter of mixed acini increased significantly by 27%, and protein diameter decreased by 11%. The average diameter of the duct system changed as follows: periacinar ducts of protein acini did not change their diameter compared to the control group, and the average diameter of periacinar ducts of mixed acini increased only by 4%. Thus, it was determined morphometrically, that in chronic frontitis compared to the control group, a vascular response that manifested by spastic capillary and dilational responses of arterioles and venules had occured in response to a chronic inflammatory process. In chronic frontitis the glands responded with reduced activity of protein glands and increased activity of mixed glands producing mucoid secret. On histological specimens, the epithelial cells of the end parts changed the cytoplasm density, and a large amount of mucus was visualized in the duct system. Along with, irregular blood filling of hemomicrocirculatory bloodflow elements and diapedesis hemorrhages were observed.