ORIGINAL RESEARCH
Does Celiac Disease Affect Smell Sensation, Mucociliary Clearance and Nasal Smear?
Çölyak Hastalığı Koku Duyusunu, Mukosiliyer Klirensi ve Nazal Smearı Etkiler mi?
Received Date : 23 Aug 2023
Accepted Date : 05 Jan 2024
Available Online : 23 Jan 2024
Güler BERKİTENa, Belgin TUTARa, Yasemin GÖKDENb, Selma ŞENGİZ ERHANc,
Semih KARAKETİRd, Sabire Sitare SARIÇAMe, Ömer KUMAŞa, Şeyma GORÇİN KARAKETİRf, Ziya SALTÜRKg, Yavuz UYARa
aOkmeydanı Prof. Dr. Cemil Taşcıoğlu City Hospital, Clinic of Otorhinolaryngology-Head and Neck Surgery, İstanbul, Türkiye
bOkmeydanı Prof. Dr. Cemil Taşcıoğlu City Hospital, Clinic of Gastroentorology, İstanbul, Türkiye
cOkmeydanı Prof. Dr. Cemil Taşcıoğlu City Hospital, Clinic of Patology, İstanbul, Türkiye
dBulanık State Hospital, Clinic of Otorhinolaryngology-Head and Neck Surgery, Muş, Türkiye
eOltu State Hospital, Clinic of Otorhinolaryngology-Head and Neck Surgery, Erzurum, Türkiye
fMalazgirt State Hospital, Clinic of Public Health, Muş, Türkiye
gAnadolu Health Center, Clinic of Otorhinolaryngology-Head and Neck Surgery, İstanbul, Türkiye
Doi: 10.24179/kbbbbc.2023-99179 - Makale Dili: EN
Journal of Ear Nose Throat and Head Neck Surgery. 2024;32(1):23-9
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: We aimed to evaluate olfactory function and nasal
smear cytology in patients of celiac disease (CD) and healthy volunteers. Material
and Methods: In this study, total 74 subjcets involved including 38 CD
diagnosed patients and 36 healthy control subjects. CD has been verified by
serological tests and small intestine biopsy. Sniffin Stick test was used to evaluate
olfactory function. Nasal mucociliary clearance (MCC) time was measured
with saccharin test. Neutrophils, eosinophils, basophilic and goblet cells
were evauluted in nasal cytology. Sniffin test findings, MCC, nasal cytology
and response to treatment with diet findings of CD patients and control group
have been compared. Results: In CD group, it is determined normosmia for 20
patients, hiposmia for 17 patients. Total smell score (TDI) has been observed
as 35±4 in control group while 31±8 in CD group. The difference between two
groups is statistically meaningful (p=0.009). While there was no statistically
significant difference between the groups in terms of discrimination (DIS) score
and identification (ID) score scores (p=0.277; p=0.960), the mean theroshold
(THR) was found to be statistically significantly lower in the CD group
(p=0.018). No evident difference has been determined between the two groups
in terms of nasal MCC duration (p=0.948). While there was no statisticaly signicant
difference in the average goblet cell grade, in terms of eosinophil, neutrophil
and lymphocyte grade average differences are meaningful (p=0.001).
There was no statistically remarkable difference between diet compliant and
non-diet compliant group in terms of THR, DIS, ID and TDI scores (p>0.05).
Conclusion: In our study, deterioration of nasal functions and nasal cytological
findings-in particularly lymphocyte infiltration-make it possible to think
that CD group is a systemic disease that affects all organs especially mucous
membranes.
Keywords: Cytology; olfactory disorders; celiac disease
ÖZET
Amaç: Çölyak hastalığı (ÇH) olan ve sağlıklı gönüllülerde koku fonksiyonunu
ve nazal yayma sitolojisini değerlendirmeyi amaçladık. Gereç ve
Yöntemler: Bu çalışmaya 38 ÇH tanısı alan hasta ve 36 sağlıklı kontrol olmak
üzere toplam 74 kişi dâhil edildi. ÇH tanısı serolojik testler ve biyopsi ile koyuldu.
Olfaktör fonksiyonu değerlendirmek için Sniffin Stick test kullanıldı.
Nazal mukosiliyer klirens [mucociliary clearance (MCC)] süresi sakkarin testi
ile ölçüldü. Nazal sitolojide nötrofil, eozinofil, bazofil ve goblet hücreleri değerlendirildi.
ÇH hastalarının ve kontrol grubunun Sniffin Stick testi bulguları,
MCC, nazal sitoloji sonuçları karşılaştırıldı. Diyet verilen ÇH hastalarında da
bu testlerdeki değişiklikler değerlendirildi. Bulgular: ÇH grubunda 20 hastada
normozmi, 17 hastada ise hipozmi belirlendi. Toplam koku puanının (TDI)
kontrol grubunda 35±4, ÇH grubunda ise 31±8 olduğu görüldü. Gruplar arasında
anlamlı fark bulundu (p=0,009). Gruplar arasında koku ayırt etme [discrimination
(DIS)] skoru ve koku tanımlama [identification (ID)] skorları
açısından istatistiksel olarak anlamlı fark bulunmazken (p=0,277; p=0,960),
çölyak grubunda ortalama eşik değer [theroshold (THR)] skorunun istatistiksel
olarak anlamlı derecede düşüktü (p=0,018). İki grup arasında MCC süresinde
fark saptanmadı (p=0,948). Ortalama goblet hücre derecesinde istatistiksel olarak
anlamlı bir fark bulunmazken, eozinofil, nötrofil ve lenfosit derecesinde
ortalama farklar anlamlıydı (p=0,001). THR, DIS, ID ve TDI skorlarında diyet
uygulayan ve diyet yapmayan grup arasında istatistiksel olarak anlamlı bir fark
saptanmadı (p>0,05). Sonuç: Çalışmamızda, nazal koku fonksiyonlarda bozulma
ve nazal sitolojik bulgularda özellikle lenfosit infiltrasyonu görüldü. ÇH
başta mukozalar olmak üzere tüm organları etkileyen sistemik bir hastalık olduğunu
çalışmamız düşündürmektedir.
Anahtar Kelimeler: Sitoloji; koku bozuklukları; çölyak hastalığı
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