Cellular components of the nasal discharge vary depending on pathologic processes of the nose and the paranasal sinuses.
Thus, the nasal discharge obtained from the common nasal cavity and the middle meatus, were studied quantitatively following the operations of the chronic paranasal sinusitis for a period of one year. These results were evaluated in conjunction to the pathologic changes of the nasal cavities and the paranasal sinuses.
Under normal and slightly diseased condition, the nasal discharge mainly consisted of the polymorphonuclear neutrophils (three nucleated neutrophils) and abundance of the cylinder epithelial cells, while the polymorphonuclear neutrophils especially 4 to 5 nucleated neutrophils, increased in number accompanied by correspondingly less epithelial cells under the chronic imflammation.
With aggravation of the chronic imflammation, the epithelial cells, especially the ciliated epithelial cells, showed marked decrease and the deeply located epithelial cells were found increased.
It was also found that the nasal discharge obtained from the common nasal cavity well reflected the mucosal pathology of the maxillary sinus and the discharge from the middle meatus corresponded to the pathology of the paranasal sinuses. In another word, it can be stated that the cellular findings of the nasal discharge well represent the pathologic processes of the nasal cavities.
Studying both findings of the discharge and the pathologic specimen of the maxillary sinus mucosa, it could be also stated that the epithelial cells were dominating cells of the nasal discharge with the well functioning sinus mucosa, and the neutrophils were found to be increased in the nasal discharge with the poorly functioning mucosa.
From 52 cases which had operations for the chronic paranasal sinusitis, 257 specimen of the nasal discharge were obtained and were subjected to detail examinations.
In results the following three types were differentiated:
Type I; cases which showed satisfactory increase of the regenerative epithelial cells with prompt decrease of the imflammatory neutrophils. These cases took good clinical courses.
Type II; cases in which the increase of the epithelial cells and the decrease of the neutrophils were observed but less in extent than Type I.
Type III; cases which revealed persistent presence of the neutrophils and relative lack of the regenerative epithelial cells.
In summary, it was concluded that the cellular findings of the nasal discharge reflected the histologic reactions fairly accurately of the nasal cavity and the paranasal sinuses.
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