兔上颌窦外侧壁截骨对上颌窦黏膜功能的影响

中国口腔颌面外科杂志 ›› 2016, Vol. 14 ›› Issue (6): 500-504.

兔上颌窦外侧壁截骨对上颌窦黏膜功能的影响

刘小郁¹, 白希婧², 杨学文¹

1.教育部口腔医学生物工程重点实验室（武汉大学）, 武汉大学口腔医学院口腔颌面创伤与整形外科,湖北武汉 430079;
2.天津市口腔医院,天津 300020

收稿日期:2016-01-25 修回日期:2016-04-08 出版日期:2016-11-20 发布日期:2016-12-05
通讯作者: 杨学文,E-mail:yangxuewen._1962@163.com
作者简介:刘小郁（1988-）,女,在读博士研究生,E-mail:liuxiaoyu402@163.com

The influence of maxillary sinus outer wall osteotomy on maxillary sinus mucosa function

LIU Xiao-yu¹, BAI Xi-jing², YANG Xue-wen¹

1.The State Key Laboratory Breeding Base of Basic Science of Stomatology Hubei-MOST & Key Laboratory of Oral Biomedicine, Ministry of Education, Wuhan University;
Department of Oral and Maxillofacial Trauma and Plastic Aesthetic Surgery, School and Hospital of Stomatology, Wuhan University. Wuhan 430079, Hubei Province;
2. Tianjin Stomatological Hospital. Tianjin 300041, China

Received:2016-01-25 Revised:2016-04-08 Online:2016-11-20 Published:2016-12-05

摘要/Abstract

摘要： 目的探讨兔上颌窦外侧壁截骨术对上颌窦黏膜功能及MUC5AC表达的影响。方法取新西兰成年兔12只,每只兔左侧为实验侧,全麻后切开龈颊沟黏膜,充分剥离,显露上颌骨前、外侧壁。上颌窦外侧壁截骨线做20 mm×2 mm上颌窦骨壁及黏膜缺损。右侧上颌窦不做任何处理作为对照侧。实验动物随机分为3组,每组4只,分别在术后2、4和8周处死一组动物。通过H-E 染色和免疫组织化学染色观察上颌窦黏膜的组织学变化过程及杯状细胞的分泌情况。采用Graphpad Prism v5.0软件包对数据进行统计学处理。结果术后2周,上颌窦黏膜附着纤毛脱落,且有腺体部分破坏、减少;术后4周,黏膜细胞水肿呈空泡样,黏膜固有层腺体、血管增生;术后8周,黏膜上皮层基本恢复正常,纤毛上皮减少、排列不完整,形态仍有异常。免疫组织化学染色发现,实验侧2、4、8周MUC5AC表达较对照侧显著增加（P<0.001）。2周时MUC5AC表达最强,4周时表达稍减弱,8 周时表达明显减弱。结论兔上颌窦外侧壁截骨术后的上颌窦黏膜分泌功能发生明显变化。随着时间推移,其组织结构在一定程度上可以自行修复,但与正常结构相比仍有一定差异。减轻手术对上颌窦及黏膜的损伤,可降低术后对其生理功能的影响。

关键词: 兔, 上颌窦外侧壁截骨, 上颌窦黏膜, MUC5AC

Abstract: PURPOSE: To investigate the expression of MUC5AC in maxillary sinus mucosa of rabbits after maxillary sinus outer wall osteotomy, and explore the influence of outer wall osteotomy on maxillary sinus mucosa function. METHODS: Twelve healthy adult New Zealand white rabbits receiving outer wall osteotomy were selected to establish surgical models. Maxillary vestibular groove mucosa was incised after general anesthesia. A 20 mm×2 mm bone and mucosa defect was established on the outer wall of the left maxillary sinus, which was used as experimental side. Right maxillary sinus was untreated as negative control group. All experimental animals were randomized into 3 groups and sacrificed 2, 4 and 8 weeks after surgery, respectively. The morphologic change of maxillary sinus mucosa and secretion of goblet cells were examined through H-E staining and immunohistochemistry. The data were analyzed by using Graphpad Prism v5.0 software package. RESULTS: Two weeks after surgery, cilium fell off from maxillary sinus mucosa, glands destroyed and decreased in number. Mucosa cells were swollen like balloons with glands proliferation 4 week after surgery. Epithelium returned to nearly normal morphology, while the proportion of cilium cells was decreased, with irregular arrangement and abnormal morphology. Immunohistochemistry showed expression level of MUC5AC in the experimental group was significantly higher than in the control group (P<0.001). Expression level was strongest in the 2-week group and slightly declined in the 4-week group, while weakest in the 8-week group. CONCLUSIONS: Maxillary sinus mucous secretion changed significantly after outer wall osteotomy. Tissue structures could repair partially over time, but are still different from normal structures. Minimizing sinus mucosal damage during surgery may reduce the impact on its physiological functions.

Key words: Rabbit, Maxillary sinus outer wall osteotomy, Maxillary sinus mucosa, MUC5AC

中图分类号:

R782.2

刘小郁, 白希婧, 杨学文. 兔上颌窦外侧壁截骨对上颌窦黏膜功能的影响[J]. 中国口腔颌面外科杂志, 2016, 14(6): 500-504.

LIU Xiao-yu, BAI Xi-jing, YANG Xue-wen. The influence of maxillary sinus outer wall osteotomy on maxillary sinus mucosa function[J]. China J Oral Maxillofac Surg, 2016, 14(6): 500-504.

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