Взаимосвязь между нарушениями цилиарного аппарата эпителия слизистой оболочки носа и тяжестью синоназальной патологии у детей с хроническим риносинуситом

Abstract

The aim of this study was to study the relationship between disorders of the ciliary apparatus of the epithelium of the nasal mucosa and the severity of sinonasal pathology in children with chronic rhinosinusitis. 186 children aged 6 to 17 years with a diagnosis of chronic rhinosinusitis were examined. The severity of sinonasal pathology was assessed by the results of computed tomography in accordance with the Lund–Mackay scale. By the method of videocytomorphometry, such parameters: the proportion of cells with mobile cilia (%), cell survival (min), the beat rate of cilia (BCC) (Hz), the length of cilia (microns) were determined. According to the distribution of data, the lowest values of the studied indicators (Q1) are regarded as pronounced violations, while the highest values (Q4) correspond to minor violations. Children with moderate and mild decrease in the proportion of cells with mobile cilia, as well as BCC, were characterized by 17 and 25%, as well as 25 and 37% lower score on the Lund-Mackay scale compared with patients with severe violations of these parameters, respectively. A marked decrease in cell survival and cilia length was also associated with a significant 25% increase in the total score on the Lund–Mackay scale relative to patients with lower severity of ciliary disorders. The gradation based on two parameters, the BCC and the length of the cilia, led to even more pronounced differences between the groups in the total assessment on the Lund–Mackay scale. The data obtained, on the one hand, confirm the role of disorders of the mucociliary apparatus in the pathogenesis of CRS and its progression, while on the other, expand the arsenal of diagnostic tools and predicting the severity of CRS in children.