Objective: To observe Effect of nasal epithelial lining prognosis and turnover changed by vesicles molecular immuno-pathology after nasal endoscopic surgery.
Method: Forty patients (80 sides) with chronic nasal polyps in accordance with the EPOS standard after endoscopic sinus surgery were randomly divided into treatment group and control group according to weather scraping the vesicles. Compared the speed of epithelialization of nasal cavity mucosa in the two groups. Observed the pathological features of vesicles through HE staining and transmission electron microscopy. Divided the treatment group into 1-3 weeks group, 6-8 weeks group and 11-14 weeks group. And make the inferior turbinate mucosa and nasal polyps during surgery the control group. Compared the level of vascular endothelial growth factor(VEGF) and transforming growth factor beta1 (TGF beta1) between the groups.
Result: Vesicles were divided into mild groups and moderate to severe groups according to the sizes and amonts. Vesicles in moderate to severe groups were faster epithelialization than the mild groups, 1.5 weeks shortened on average (P < 0.05). There wes no significant difference between the two groups in mild group. The level of TGF beta1 in the nasal polyps, 1-3 weeks group and 6-8 weeks group were significantly higher than the inferior turbinate mucosa and 11-14 weeks group (P < 0.05). The level of VEGF in the nasal polyps, 6-8 weeks group were significantly higher than the inferior turbinate mucosa, 1-3 weeks group and 11-14 weeks group (P < 0.05). Vesicles were displayed discontinuous basal membranes, interstitial edama, infiltration of inflammatory cells, increased pathological glands, abnormal microtubule structure, reduction of mitochondrials.
Conclusion: Vesicles is a dynamic process, which may predict the increased levels of inflammatory factors (VEGF and TGF beta1) and contribute to some of the patheologic changes observed in nasal polyps. The level of VEGF and TGF beta1 in vesicles after endoscopic sinus surgery can be used as indicators of prognosis. Treating the moderate to severe vesicles after surgery is benefit to the epithelium of the nasal mucosa.