Abstract

Objective: Blockade of the ostiomeatal complex is the main pathogenic factor in the development of chronic rhinosinusitis, so the study of changes in the mucous membrane in this area will allow the development of new methods of treatment of chronic rhinosinusitis.

The purpose of the study is to investigate changes in the mucosa of the ostiomeatal complex in chronic rhinosinusitis.

Materials and methods: The study used surgical material – the mucous membrane of the ostiomeatal complex, which was obtained during FESS. Histological preparations were made from the material according to the generally accepted method, which were stained with histological and histochemical stains: H&E, according to the Mallory and H&E – with alcian blue. Immunohistochemical studies were performed using monoclonal antibodies to a specific marker of B lymphocytes and their derivatives – CD-20.

Results and discussion: In chronic rhinosinusitis a goblet-cell transformation of the epithelium or its partial desquamation occurs. In the submucosal layer – diffuse leukocytic-lymphocyte infiltration. Intraepithelial macrophages phagocytose antigens and the formed immunological determinants penetrate into the submucosal layer where contact with labrocytes, as a result an allergic reagin reaction develops. During degranulation of labrocytes inflammatory mediators are released which increase the permeability of blood vessels which promotes the emigration of B-lymphocytes. Plasma cells synthesize immunoglobulins that can penetrate through the intercellular spaces of the damaged ciliated epithelium to its free surface. Purulent exudate that appears on the surface of the mucosa consists of thick mucus with changed rheology due to goblet-cell transformation and hypersecretion of mucous glands, neutrophilic, eosinophilic leukocytes and immunoglobulins.

Conclusions:

1. In the case of exacerbation of chronic rhinosinusitis, goblet-cell transformation of the epithelium or its partial desquamation occurs in the ostiomeatal complex and in the own layer there is a pronounced diffuse leukoplasmocyte infiltration.
2. Purulent exudate formed on the surface of the mucosa consists of thick mucus, as well as neutrophilic and eosinophilic leukocytes and immunoglobulins.

Key words: ostiomeatal complex, mucosa, nasal cavity.