Remodeling in Chronic Sinusitis and Nasal Polyps

Remodeling in chronic sinusitis and nasal polyps is discussed. In chronic sinusitis, epithelial shedding, which is characteristic of asthma, is not observed in the maxillary sinus. An increase of mirovillous cells, squamous metaplasia, and goblet cells is observed in many patients with chronic sinusitis. The decreased ciliary area increases postoperatively in the maxillary ostium and in the maxillary sinus. There is no significant difference in the number of goblet cells between normal controls and chronic sinusitis. On the other hand, the number of submucosal acinar cells in chronic sinusitis is significantly higher than that in normal controls. Nasal polyps show a diversity of histogical findings. Although squamous metaplasia and goblet cells hypertrophy is observed in many patients, epithelial shedding, which is characteristic of asthma, is not observed in nasal polyps. The most striking finding of glands in nasal polyps is long shape. Histochemical analysis reveals deposition of types I, III, and V collagens in nasal polyps. Myofibroblasts, which are abundant in nasal polyps but rare in nasal mucosa, could be involved in the growth process of nasal polyps by inducing extracellular matrix accumulation. Although accumulation of extracellular matrix is a main feature of nasal polyps, its pathogenesis is not clearly known.