Study Of Matrix Metalloproteinase 9 And Histopathology In Sinonasal Diseases Before And After Endoscopic Surgery

Abstract

BACKGROUND:. Headache and facial pain are one of the most common symptoms encountered in day to day ENT practice. One of the reasons for this is disease of sinomucosa which causes distress to the patient in carrying out their daily activities. Incomplete treatment of these diseases leads to chronicity. Understanding the pathogenesis and the changes occurring at molecular and histological level in the sinonasal mucosa can help in better outcome of treatment. Methods: A comparative study was carried in 55 patients with sinonasal disease in the ENT dept from November 2017 to June 2019.All 55 patients underwent Endoscopic Surgery. Nasal mucosa biopsies was taken (preoperatively and postoperatively 1st, 3rd and 6 month) for histopathological study. Concentration of MMP-9 was measured by using commercially available ELISA. RESULTS: The present study was conducted in 55 patients presenting with sinonasal diseases who underwent FESS. It was found that MMP-9 value significantly decreased over time(P<0.05).The fall of mean MMP-9 was maximum (53%) from pre-op to 1month which subsequently subsidized from previous value. Histopathological findings like presence goblet cell hyperplasia ,inflammatorycells,stromal edema and angiogenesis were found to be positvely correlated with higher level of MMP-9 values. These findings were consistent over the follow up time of 1st,3rd and 6th month.It was also found that the presence .of fibrosis was negatively correlated with the level of MMP-9 CONCLUSION: Expression of MMP-9 in epithelium was positively and statistically significantly correlated with a higher number of inflammatory cells in nasal epithelium and mucosa. A decreased number of inflammatory cells, decline in hypertrophy of the mucous glands indicate a positive effect of treatment on the inflammatory process, which may also account for a more functional nasal epithelium and lower nasal airway resistance. This may also account for the post treatment improvement of symptoms and in quality of life.