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Dr. Samer Badee Kamel :: Publications:

A Deeper View in the Pathogenesis of Vasomotor Rhinitis
Authors: Hany Amin , Elham Ibrahiem Sief , Samer Badee, Taha Mohammed and Sayed Kadah
Year: 2015
Keywords: VMR, electron microscopy & pathogenesis.
Journal: Journal of American Science
Volume: 9
Issue: 10
Pages: 115
Publisher: J Am Sci 2013;9(10):115-119]. (ISSN: 1545-1003).
Local/International: International
Paper Link: Not Available
Full paper Samer Badee Kamel_SAMER BADEE.pdf
Supplementary materials Not Available

Abstract: Introduction: Vasomotor rhinitis cause nasal symptoms that occur in response to environmental conditions, such as changes in temperature or relative humidity, odours (e.g., perfumes or cleaning materials), passive tobacco smoke, alcohol, sexual arousal, and emotional factors. Such hyper-reactivity to nonallergic triggers is not mediated by increased neural efferent traffic to the blood vessels supplying the nasal mucosa. It can also occur in allergic rhinitis, when the term mixed rhinitis is applied. Objectives: The present study aimed to study the pathogenesis of VMR by electron microscopy to see if there is another cause for this disease. Material and Methods: It was a prospective randomised study which was held at Benha Faculty of Medicine, in the period from January 2009 to November 2011. It was conducted on 45 patients divided into two groups. The study was carried out in a group of 39 patients (21 males, 18 females; age range 25- 38 years) with VMR and 6 control patients (4 males, 2 females; age range 22- 34 years). Study Group The patients were affected by typical symptoms of VMR, consisting of nasal obstruction and profuse watery rhinorrhoea. Based on the personal history of the patients, these symptoms had been present for a period of at least 2 years (range 2-6 years). At anterior rhinoscopy, the turbinate were hypertrophied causing significant obstruction of the nasal cavities .Control Group Six patients who were doing other ENT operations with no nasal complaints nor diseases. Methodology: Electron microscopy was done for them. Specimens were fixed in cacodylate buffered formaldehyde glutraraldehyde-R. Post fixed in buffered 1%osomium tetraoxide, dehydrated and embedded in spurris resin. Ultrathin section were double stained by 10 % Reynolds lead citrate. Examination was done by TEM (philipo400). Results: The electron microscopic sections of patients with VMR showed loss of intercellular junction with separated cells, cilia are shorter, sparce and deformed, apoptic cells in the epithelial layer, the epithelial cells are full of vesicles and goblet cells. Another type of secretory glands are also seen, loss of the smooth surface of endothelial cells and the basal lamina is thickened. Conclusion: The pathology of the vasomotor rhinitis starts first in the submucosal vessels with angiopathy similar to the diabetic angiopathy then the epithelial changes take place. Surgical or Medical treatment directed to the sympathetic system may or may not improve the case depending mainly on how much the submucosal blood vessels are affected.Presence of another type of secretory granules in the submucosal glands need more histochemical studies.

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