Evaluation of mucosal changes of nasal packs with sesame oil and nitrofurazon: Experimental study

Öz

Objectives: Our study was aimed to determine histolog-ical and microbiological changes in the nasal mucosa of adult rabbits, after the application of nasal tampons prepared with sesame oil and nitrofurazone. Methods: Thirty-two adult rabbits were divided into 6 groups. Tampons coated with sesame oil in groups 1 and 4, nitrofurazone in groups 2 and 5, saline in groups 3 and 6 were inserted in left nasal passage. Tampons in all groups were removed after 48 hours. Culture samples were taken from nasal passages of groups 1, 2 and 3 under sterile conditions. After those rabbits were decap-itated and the nasal complex containing the nasal muco-sa and septum were excised and sent to the histology laboratory. Same steps were repeated on the 5th day in groups 4, 5 and 6. Samples taken from nasal passages were planted on blood agar and eosin methylene blue media with streak plate method and evaluated. Nasal septum mucosa samples were stained with hematoxy-lin-eosin. Samples were examined under light micro-scope for loss of cilia, edema, congestion and goblet cell increase; and scored (0: None, 1: Mild, 2: Moderate, 3: Severe). Same samples were also evaluated according to inflammatory cell scoring (1: Mild, 2: Moderate, 3: Severe). Results: Normal bacterial flora was detected in cultures taken from nasal mucosa in all groups. It was observed that Gram negative bacteria were more dominant than Gram positive bacteria. In the histopathological exami-nation of the samples taken from the nasal septum mu-cosa on the 1st and 5th days; there was no significant difference in edema, cilia loss, goblet cell increases and congestion in sesame oil, nitrofurazone and saline groups. In the samples taken on the 5th day, it was ob-served that the inflammatory cell density was higher in the nitrofurazone group which was statistically signifi-cant. (p=0.002). Conclusion: In our study; histologically less inflamma-tory cell increase was observed in the nasal mucosa on the 5th day in the sesame oil group. However, the histo-logical and microbiological effects of sesame oil were similar to nitrofurazone and saline. To determine the efficacy of sesame oil on nasal mucosa prospective clinical studies with more subjects are needed.

Anahtar Kelimeler

• Sesame oil
• nitrofurazone
• nasal mucosa
• polyvinyl acetal

Susam yağı ve nitrofurazon içeren burun tamponlarının oluşturduğu mukoza değişikliklerinin incelenmesi: Deneysel çalışma

Öz

Amaç: Çalışmamızda, susam yağı ve nitrofurazon ile hazırlanan tamponların erişkin tavşana uygulanması sonrası nazal mukozadaki histolojik ve mikrobiyo-lojik değişikliklerin tespit edilmesi amaçlanmıştır. Yöntem: Otuz iki yetişkin tavşan 6 gruba ayrıldı. Grup 1 ve 4’ e susam yağı, grup 2 ve 5’e nitrofurazon ve grup 3 ve 6 ya serum fizyolojik ile hazırlanan tampon sol nazal pasaja konuldu. Tamponlar 48 saat sonra tüm gruplardan çekildi. Steril şartlar altında grup 1, 2 ve 3’ün nazal pasajlarından alınan kültür örnekleri mikrobiyoloji laboratuvarına gönderildi. Ardından tavşanlar dekapite edildi ve nazal mukoza ve septumu içeren burun kompleksi histoloji labora-tuvarına gönderildi. Aynı işlemler 5. günde grup 4, 5 ve 6’ya tekrarlandı. Nazal pasajlarından alınan ör-nekler kanlı agar ve eozin metilen blue besi yerlerine çizgi ekim tekniği ile ekilip değerlendirildi. Nazal septum mukoza örnekleri hematoksilen-eozin ile boyandı ve ışık mikroskopu ile silya kaybı, ödem, konjesyon ve goblet hücre artışı incelenerek, 0: Yok, 1: Hafif, 2: Orta, 3: Ağır derece ve inflamatuvar hücre skorlaması 1: hafif, 2: orta, 3: ağır derece ola-rak değerlendirildi. Bulgular: Bütün gruplarda nazal mukozadan alınan kültürlerde normal flora bakterileri ürediği saptandı ve Gram negatif bakterilerin Gram pozitif bakteri üremesine göre daha baskın olduğu görüldü. Nazal septum mukozasından alınan parçaların histopatolo-jik incelemesinde 1. ve 5. gün susam yağı, nitrofura-zon, serum fizyolojik gruplarında ödem, silya kaybı, goblet hücre artışı ve konjesyon açısından anlamlı farklılık gözlenmedi. 5. gün nitrofurazon grubunda inflamatuvar hücre yoğunluğunun daha fazla olduğu görüldü. Bu durumun istatiksel olarak anlamlı oldu-ğu saptandı (p=0.002). Sonuç: Çalışmamızda; histolojik olarak nazal mu-kozalarda susam yağı grubunda 5. günde daha az oranda inflamatuvar hücre artışı gözlenmiştir. Bu-nunla birlikte susam yağının histolojik ve mikrobi-yolojik etkileri nitrofurazon ve serum fizyolojiğe benzer çıkmıştır. Susam yağının mukoza üzerine etkinlikteki rolünü belirlemek için daha fazla denek sayısı ile ileriye yönelik klinik çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Susam yağı
• nitrofurazon
• nazal mukoza
• polivinil asetal

Kaynakça

1. 1. Johnsen J, Bratt BM, Michel-Barron O et al. Pure sesame oil vs isotonic sodium chloride solution as treatment for dry nasal mucosa. Arch Otolaryngol Head Neck Surg 2001;127(11):1353-6.
2. 2. Yasan H, Dogru H, Çandır Ö et al. The Effects of wound healing agents’ application following nasal and paranasal sinus surgery. KBB Forum 2005; 4(2):89-94.
3. 3. Hildenbrand T, Weber RK, Brehmer D. Rhinitis sicca, dry nose and atrophic rhinitis: A review of the literature. Eur Arch Otorhinolaryngol 2011;268(1):17-26.
4. 4. Süslü AE, Şereflican M, Sırmatel F ve ark. Microbio-logical comparison of polyvinyl acetal and fingerstall packs following endonasal surgery. KBB ve BBC Der-gisi 2009;17 (2):50-3.
5. 5. Dubin MR, Pletcher SD. Postoperative packing after septoplasty: Is it necessary? Otolaryngol Clin North Am 2009;42(2):279-85.
6. 6. Shaw CL, Dymock RB, Cowin A et al. Effect of pac-king on nasal mucosa of sheep. J Laryngol Otol 2000;114(7):506-9.
7. 7. Saab BR, Pashayan N, El-Chemaly S et al. Sesame oil use in ameliorating cough in children: A randomised controlled trial. Complement Ther Med 2006;14(2):92-9.
8. 8. Feldman C, Anderson R, Theron AJ et al. Vitamin E attenuates the injurious effects of bioactive phospho-lipids on human ciliated epithelium in vitro. Eur Res-pir J 2001;18(1):122-9.

9. 9. Weber RK. Nasentamponaden und stents [nasal packing and stenting]. Laryngorhinootologie 2009;88 Suppl 1:S139-55.
10. 10. Weber R, Keerl R, Hochapfel F et al. Packing in endonasal surgery. Am J Otolaryngol-Head Neck Med Surg 2001;22(5):306-20.
11. 11. Ohashi Y, Nakai Y, Ikeoka H et al. Regeneration of nasal mucosa following mechanical injury. Acta Oto-laryngol Suppl 1991;486:193-201.
12. 12. Mohamed HMA, Awatif II. The use of sesame oil unsaponifiable matter as a natural antioxidant. Food Chem 1998;62(3):269-76.
13. 13. Fukuda Y, Osawa T, Namiki M et al. Studies on antioxidative substances in sesame seed. Agric Biol Chem 1985;49:301-6.
14. 14. Wu MS, Aquino LBB, Barbaza MYU et al. Anti-inflammatory and anticancer properties of bioactive compounds from Sesamum indicum L.-A review. Mo-lecules 2019;24(24):4426.
15. 15. Björk-Eriksson T, Gunnarsson M, Holmström M et al. Fewer problems with dry nasal mucous membranes following local use of sesame oil. Rhinology 2000,38(4):200-3.
16. 16. Feenstra JF, Rixon K, Hukins C. A randomised single-blinded cross-over trial of sesame oil (“nozoil [tm]”) for the treatment of nasal symptoms associated with CPAP. Chest 2005;128(4):232S.
17. 17. Geronemus RG, Mertz PM, Eaglstein WH. Wound healing. The effects of topical antimicrobial agents. Arch Dermatol 1979;115(11):1311-4.
18. 18. Tierno PM Jr, Hanna BA. Magnesium and the pro-duction of toxic-shock-syndrome toxin-1 by Staphy-lococcus aureus. J Infect Dis 1986;153(5):994-6.
19. 19. Ryan A, Kaplan E, Laurieri N et al. Activation of nitrofurazone by azoreductases: Multiple activities in one enzyme. Sci Rep 2011;1:63.