Pathomorphological changes of the Schneiderian membrane in the mixed form of iatrogenic maxillary sinusitis of stomatogenic origin

Authors

  • S. D. Varzhapetyan SE «Zaporizhzhia Medical Academy of Postgraduate Education of MOH of Ukraine»,
  • E. А. Grigorieva Zaporizhzhia State Medical University,

DOI:

https://doi.org/10.14739/2310-1237.2016.2.80890

Keywords:

Еpithelium, Maxillary Sinuses, Maxillary Sinusitis, Respiratory Mucosa

Abstract

Objective: To study the morphological changes of the Schneiderian membrane in the mixed form of iatrogenic maxillary sinusitis of stomatogenic origin.

Material and methods. Reactive changes of the mucous membrane of the maxillary sinus were studied in 24 (100 %) patients with the presence of a foreign body in the lumen of the sinus. To differentiate the observed changes in the mucosa Manasse’s pathomorphologic classification was used. Immunohistochemical reaction with monoclonal antibodies CD 8, CD 56, CD 68, CD 138, CD 43 was carried out. Photo documentation was constituted by the computer system, binocular microscope Axiolab, digital camera Axiocam and «AxioVision 4.8» software. Statistical processing of the results was carried out according to the tables of R. B. Strelkov. The significance of differences of the results was estimated using the Student-Fisher method for the confidence level of not less than 95 %, which is common for biological and medical research (p<0.05).

Results of the study. Fibrous-form infiltration was noted in 66.7±9.6 % of cases, granulosa – 25.0±8.8 % and cystic in 8.3±5.6 %. Cellular composition of lamina propria mucosae was represented by fibroblasts, fibrocytes, macrophages, lymphocytes, plasma cells. The presence of eosinophils in a large amount indicates the presence of local allergic reaction, the presence of segmented neutrophils infiltrate indicates the presence of the secondary infection. The biopsies revealed CD 8+-lymphocyte cells, numerous CD 68+ macrophages, single CD 43+ and CD 138+ cells. CD 56+ cytotoxic lymphocytes have not been identified. Among the reactive changes in the epithelium absence of the ciliary cover prevails in 83.3±7.6 % of observations, necrosis – 66.7±9.6 %, squamous metaplasia of the epithelium – in 50.0±10.2 % of cases, hyperplasia – in 25.0±8.8 %.

Conclusions. Mixed form of iatrogenic sinusitis corresponds to fibrous infiltration, granulosa and cystic patomorphologic forms according to Manasse, cellular composition of lamina propria mucosae was represented by fibroblasts, fibrocytes, macrophages, lymphocytes, plasma cells. The presence of eosinophils in a large amount indicates the presence of local allergic reaction, the presence of segmented neutrophils infiltrate indicates the presence of the secondary infection; among the reactive changes in the epithelium absence of the ciliary cover, necrosis, squamous metaplasia of epithelium and hyperplasia prevail.

References

Bystrova, O. V. (2011) Povyshenie e´ffektivnosti lecheniya pacientov s khronicheskimi verkhnechelyustnymi sinusitami, vyzvanymi stomatologicheskimi plombirovochnyimi materialami (Avtoref. dis…kand. med. nauk). [Improving the efficiency of the treatment of patients with chronic maxillary sinusitis caused by dental filling materials] (Extended abstract of candidate’s thesis). Moscow. [in Russian].

Sipkin, A. M., Nikitin, A. A., Lapshin, V. P., Chukumov, R. M., & Kryazhinova, I. A. (2013) Verkhnechelyustnoj sinusit: sovremenyj vzglyad na diagnostiku, lechenie i reabilitaciyu [Maxillary sinusitis: a contemporary view on the diagnosis, therapy and rehabilitation]. Almanakh klinicheskoj mediciny, 28, 82–87. [in Russian].

Gulyuk, A. G., & Varzhapetyan, S. D. (2015) Obosnovanie klassifikacii yatrogenykh verkhnechelyustnykh sinusitov stomatogennogo proiskhozhdeniya [Justification classification of iatrogenic maxillary sinusitis of somatogenic origin]. Innovatsii v stomatolohii, 2, 27–38. [in Ukrainian].

Gumovskij, A. N., Bondar´ A. V., Kim, A. R., Bocharov, V. C., Grakhova, N. V., & Ogon´yanc, K. B. (2015) Immunocity slizistoj obolochki pri odontogennom verkhnechelyustnom sinusite [Immune cells in mucos shell with odontogenic maxillary sinusitis]. Mezhdunarodnyj studencheskij nauchnyj vestnik, 2, 199–199. [in Russian].

Daminov, R. O. (2010) Vospaleniye verkhnechelyustnoj pazukhi posle operacii dental´noj implantacii i sinus-liftinga [Maxillary sinus inflammation after operation of dental implantation and sinus lifting]. Stomatologiya, 5, 59–62. [in Russian].

Likhachev, A. G. (1963) Mnogotomnoe rukovodstvo po otorinolaringologii. Tom 3. Zabolevaniya verkhnikh dykhatel´nykh putej [A multivolume guide to otolaryngology. Volume 3. Diseases of the upper respiratory tract]. Moscow. [in Russian].

Solovykh, A. G., Angotoeva, I. B., & Avdeeva, K. S. (2014) Yatrogennyj odontogennyj gajmorit [Iatrogenic odontogenic maxillary sinusitis]. Rossijskaya rinologiya, 4(22), 51–56. [in Russian].

Filonenko, T. G., Kilessa, A. V., & Golubinskaya, E. P. (2012) Osobennosti lokalizacii CD8 limfocitov v slizistoj obolochke dvenadcatiperstnoj kishki pri glyutenovoj e´nteropatii [Localization CD8 lymphocytes in the duodenal mucosa during celiac disease]. Krymskij zhurnal e´ksperimental´noj i klinicheskoj mediciny, 2, 1–2(5–6), 133–135. [in Ukrainian].

Reva, I. V., Reva, G. V., Yamamoto, T., Tolmachev, V. Е., Pervov, Yu. Yu., Dogadina, N. A., et al. (2014). Kharakteristika immunocitov CD4/CD8 slizistoj obolochki v patogeneze odontogennogo verkhnechelyustnogo sinusita [Feature immunocytes CD4/CD8 of mucous membrane in pathogenesis odontogenic maxillary sinusitis]. Fundamentalnyie issledovaniya, 10, 160–165. [in Russian].

Chernij, V. I., & Nesterenko, A. N. (2007) Narusheniya immuniteta pri kriticheskikh sostoyaniyakh: osobennosti diagnostiki [Violations of immunity in critical conditions: diagnostic features]. Vnutrennyaya medicina, 4(4), 12–23. [in Ukrainian].

Lee, K. C., & Lee, S. J. (2009) Clinical features and treatements of odontogenic sinusitis. Yonsei Med J, 51(6), 932–937. doi: 10.3349/ymj.2010.51.6.932.

Manea, C., & Sarafoleanu, C. (2015) Iatrogenic foreign bodies in the maxillary synus: between malpraxis and medico-legal consequences. Rom J Leg Med, 23(1), 14–18. doi: 10.4323/rjlm.2015.14.

Biblioteka «Zdorov’ia Ukrainy» [Library "Health of Ukraine"]. Retrived from http://www.dovidnyk.org/dir/21/118/1296.html. [in Ukrainian].

Downloads

How to Cite

1.
Varzhapetyan SD, Grigorieva EА. Pathomorphological changes of the Schneiderian membrane in the mixed form of iatrogenic maxillary sinusitis of stomatogenic origin. Pathologia [Internet]. 2016Oct.27 [cited 2024Apr.24];13(2). Available from: http://pat.zsmu.edu.ua/article/view/80890

Issue

No. 2 (2016)

Section

Original research

License

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Лицензия Creative Commons
    1. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

  1. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).