Abstract
Nasal breathing is completely ceased after total laryngectomy. This results in some structural changes in the nasal mucosa, which has been described in numerous studies. This study investigates the changes that appear in the paranasal sinus mucosa. Eight patients who had undergone total laryngectomy at least 1-year ago were enrolled. Under general anesthesia, maxillary sinuses were examined with an endoscope inserted through canine fossa. 1–2 mm mucosal tissues for biopsy were taken from posterior wall of the maxillary sinus. Specimens were evaluated under an electron microscope. Control tissues for biopsy were obtained from two patients who had been operated for other reasons and analyzed under transmission electron microscopy. Results showed that in the control specimens, the epithelial cells appeared normal under transmission electron microscopy. Samples taken from two larygectomees in their first postoperative year were also completely normal. Samples from other larygectomees demonstrated ciliary loss, abundant degenerative vacuoles in ciliated epithelial cells and detachments in the interepithelial junctional complexes. The intracellular respiratory mechanisms such as the mitochondria, golgi complex and endoplasmic reticulum cisternae, and the integrity of the cellular or the nuclear membrane were spared. We conclude that the cessation of nasal breathing resulted in degenerative changes that could be reversible in the transmission electron microscopic examination of maxillary sinus mucosa. These changes emerged after 2 years following total laryngectomy. Nevertheless, these changes did not have any negative influence on the clinical outcome in this group of patients.
Similar content being viewed by others
References
Boyce J, Eccles R (2006) Do chronic changes in nasal airflow have any physiological or pathological effect on the nose and paranasal sinuses? A systematic review. Clin Otoloaryngol 3:15–19
Stierna PLE (2001) Physiology, mucociliary clearance, and neural control. In: Kennedy DW, Bolger WE, Zinreich SJ (eds) Diseases of the sinuses, diagnosis and management, 2nd edn. Decker Inc., London, pp 35–45
Drettner B (1982) The paranasal sinuses. In: Proctor DF, Anderson I (eds) The nose: upper airway physiology and the atmospheric environment. Elsevier Biomedical Press, Amsterdam, pp 145–162
Moore-Gillon V (1985) The nose after laryngectomy. J R Soc Med 78:435–439
Toskala E, Nuutinen J, Rautinen M, Torkkeli T (1995) The correlation of mucociliary transport and scanning electron microscopy of nasal mucosa. ACTA ORL (Stockholm) 115:61–65
Maurizi M, Paludetti G, Almadori G, Ottaviani F, Todisco T (1986) Mucociliary clearance and mucosal surface characteristics before and after total laryngectomy. Acta Otolaryngol 102:136–145
Hellin Meseguer D, Merino Galvez E, Garcia Ortega F, Rosique Arias M (1996) The mucociliary function and the morphology of the nasal mucous membrane in laryngectomees compared with normal subjects. An Otorrinolaringol Ibero Am 23:81–90
Mogensen C, Tos M (1978) Experimental surgery on the nose. I. Airflow and goblet-cell density. Acta Otolaryngol 86:289–297
Sesterhenn AM, Fiedler G, Müller HH, Wiegand S, Folz BJ, Werner JA (2008) Incidence of sinunasal disease in laryngectomized patients. ORL J Otorhinolaryngol Relat Spec 70:185–188
Ozgursoy OB, Dursun G (2007) Influence of long-term airflow deprivation on the dimensions of the nasal cavity: a study of laryngectomy patients using acoustic rhinometry. Ear Nose Throat J 86(488):490–492
Cvetnic V, Sips D (1988) Clinical and cytomorphological alterations of nasal mucosa in laryngectomized patients. Rhinology 26:183–189
Fisher EW, Lund VJ, Rutman A (1992) The human nasal mucosa after deprivation of airflow: a study of laryngectomy patients. Rhinology 30:5–10
Toskala E, Rautiainen M, Nuutinen J (1994) Scanning and transmission electron microscopic findings in cilia from human nasal turbinate and sinus mucosa following respiratory infections. Eur Arch Otorhinolaryngol 251:76–79
Joki S, Toskala E, Saano V, Nuutinen J (1998) Correlation between ciliary beat frequency and the structure of ciliated epithelia in pathological human nasal mucosa. Laryngoscope 108:426–430
Toskala E, Nuutinen J, Rautiainen M (1995) Scanning electron microscopy findings of human respiratory cilia in chronic sinusitis and in recurrent respiratory infections. J Laryngol Otol 109:509–514
Inanli S, Tutkun A, Batman C, Okar I, Üneri C, Şehitoğlu MA (2000) The effect of endoscopic sinus surgery on mucociliary activity and healing of maxillary sinus mucosa. Rhinology 38:120–123
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Özdemir, İ., Öztürkcan, S., Bağrıyanık, A. et al. The maxillary sinus after total laryngectomy: an electron microscopic study. Eur Arch Otorhinolaryngol 267, 715–720 (2010). https://doi.org/10.1007/s00405-009-1128-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-009-1128-z