Cytological examination of nasal mucosa in children with perennial allergic rhinitis and adenoidal hypertrophy - the influence of adenoidectomy
Piotr Rapiejko, Marek Modrzyński, Paweł Grochowski, Edward Zawisza
CaseRepClinPractRev 2004; 5:450-455
Available online: 2004-04-20
Background: Cytological examination is commonly used nowadays, however cytological evaluation of nasal mucosa in children with adenoidal hypertrophy is sparsely described in medical literature.
The objective of this work was also to evaluate the effect of adenoidectomy on cytological findings in nasal mucosa in children with adenoidal hypertrophy and concomitant perennial allergic hinitis.Material/Methods: The study included 36 children (16 girls and 20 boys aged between 4 and 9; mean age: 5.9 years), presenting with signs of perennial allergic rhinitis (clinical symptoms, positive skin tests and sIgE for dust mites) and adenoidal hypertrophy. All children had undergone adenoidectomy. The control group included 12 non-allergic (negative skin tests and sIgE for dust mites) children of similar age with adenoidal hypertrophy in whom adenoidectomy also had beenperformed. Three cytological assays were carried out in all children: the first about one week prior to surgery, the second at three weeks and the third at six months following surgery.Results: Cytograms obtained from the nasal mucosa reverted closer to normal (no eosinophils, neutrophils < 20%) in the majority of patients following adenoidectomy. In the case of concomitant allergy of the upper respiratory tract, the above effect was not permanent with respect to eosinophils because eosinophils tend to remain stable following adenoidectomy although there is a non-permanent decrease following surgery (statistically significant increase after six months in allergic group). During the analysis of the epithelial cells, the greatest difference was noted within the goblet cell population. In the “nasal steroid group” the number of squamous epithelial cells was significantly increased.Conclusions: Allergological diagnostic studies are indicated in children with adenoidal hypertrophy and, in confirmed cases, appropriate treatment of the concomitant allergic rhinitis should be commenced.
Keywords: adenoidal hypertrophy, nasal cytology, Adenoidectomy