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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
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.
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.
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