This interesting and unique paper not only demonstrates that biopsy of olfactory mucosa in the region of the superior turbinate is a safe procedure but also provides valuable insight into an engaging area of research by a world class team in London. Olfactory ensheathing cells, found in the superior turbinate, are capable of support, nurture and regeneration of neural tissue including the re-myelination of axons, regeneration of the olfactory system and the ability to migrate and exist in both the peripheral and central nervous systems. This has important implications for the future regeneration of neural tissue in spinal cord and brachial plexus injuries and their harvest needs to be safe and done without causing detrimental effect. This ongoing research is supported by tissue from their department taken during FESS procedures and this study aims to prove that this is safe and effective. One hundred and thirty-one patients were recruited, having sinus surgery due to a variety of reasons. The two arms of the study were based on whether a superior turbinate biopsy was taken or not. Patents were not strictly randomised but those that did not want a biopsy were placed in the control arm of the study. Patients were well matched and underwent standardised, validated outcome measures preoperatively, postoperatively and at six months. Data collected includes the UPSIT, SNOT-22, VAS, NOSE, Lund-Kennedy scores, amongst others. No significant difference between the two groups was found, demonstrating that unilateral superior turbinate, olfactory mucosa harvest is a safe procedure in terms of patient morbidity, nasal function and olfactory outcome. There was also a significant increase in subjective VAS scores for olfaction postoperatively as is usually seen post-FESS although this was not mirrored in the objective UPSIT tests. This also raises the question: would patients reporting an increase in olfaction post-op have had yet further increase had their superior turbinate not been biopsied? However, I think this unlikely. 

Safety of human olfactory mucosal biopsy for the purpose of olfactory ensheathing cell harvest and nerve repair: a prospective controlled study in patients undergoing endoscopic sinus surgery.
Andrews P, Poirrier AL, Lund VJ, Choi D.
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Suki Ahluwalia

Cairns Hospital / James Cook University, Queensland, Australia.

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