NAPIITHOL ORANGE 



218 



NASAL CELL SMEARS 



in salicylic acid balsam. Connective 

 tissue, green; muscle and cytoplasm, 

 pink. 



Y (CI, 2) — fast printing green, Gam- 

 bine — An acid nitroso dye apparently 

 not used in histology. 



Naphthol Orange, see Orange L 



Naphthol Red S, C or O, see Amaranth. 



Naphthol Yellow, see Martins Yellow. 



Naphthyl Red (CI, 856), a basic dye of light 

 fastness 5. Only nuclei of mature plant 

 cells colored fugitive red (Emig, p. 57). 



Naphthylamine Brown (CI, 170), an acid 

 monoazo dye which stains plant tissues 

 darker in presence of potassium bi- 

 chromate (Emig, p. 34). 



Naphthylamine Pink, see Magdala Red. 



Naples Yellow, an exogenous pigment — 

 Pb3(Sb04)-.— Lillie, p. 134. 



Narcein (CI, 152). An acid mono-azo dye. 

 Was used by Ehrlich in combination 

 with pyronin and methylene blue or 

 methyl green to produce a neutral dye 

 (Conn, p. 54). No longer available. 



Nasal Cell Smears — Written by Marian 

 Pfingsten Bryan, Dept. of Otolaryngol- 

 ogy, Washington University, St. Louis 

 10, Mo.— September 14, 1951— Since 

 1927 the study of the cytology of nasal 

 secretions has been recognized as an 

 important aid in the clinical diagnosis 

 and differentiation of certain nasal and 

 sinus conditions. Eyerman, C. H., 

 one of the early investigators (Ann. 

 Otol., Rhinol. and Laryngol., 1927, 36, 

 808-815), identified the main tj^pes of 

 cells found in nasal secretion. Tillot- 

 son, R. S. (Arch. Otolaryng., 1929, 10, 

 262-265) reported on the value of cyto- 

 logic studies in the diagnosis of sphen- 

 oiditis. Sewall, E. C. and Hunnicut, 

 L. (Arch. Otolaryng., 1929, 10, 1-15) dis- 

 cussed cytologic examination of the 

 antrum. Dean, L. W. (J. A. M. A., 

 1932, 99, 543-546) emphasized the sig- 

 nificance of the nasal smear in helping 

 to diagnose allergy of the nose and si- 

 nuses. Hansel, F. K. (J. Allergy, 1934, 

 5, 357) contributed many observations 

 on the cytology of these secretions, es- 

 pecially in regard to allergy of the nose 

 and paranasal sinuses. There is a good 

 review of the numerous articles in the 

 literature dealing with nasal cytology 

 by Hansel, F. K., Allergy of the Nose 

 and Paranasal Sinuses, St. Louis: C. V. 

 Mosby Co., 1936, p. 383. 



The particular emphasis has been on 

 the number of eosinophilic cells in rela- 

 tion to neutrophiles; but, as knowledge 

 has progressed in nasal cytology, the 

 value of the study of smears has been 

 extended. The objectives of nasal and 

 sinus cytology include the following: 

 First, the demonstration of eosinophiles 

 in the secretions in relation to neutro- 



philes may be helpful in distinguishing 

 allergic conditions from infections, or 

 in establishing the coexistence of both. 

 In the second place the method makes 

 possible detailed observations of the 

 ciliated columnar epithelial cells, ex- 

 foliated in the early stages of acute 

 upper respiratory infections. These 

 studies may aid further in differentiat- 

 ing the common cold from allergic 

 rhinitis. Thirdly the smear technique 

 proves to be a reliable help, along with 

 biopsy, in the diagnosis of carcinoma, 

 other tumors and lesions of the upper 

 respiratory tract. Fourth, for the 

 microscopic study of radiation changes 

 produced in cells after treatment with 

 x-ray and radiation, it is invaluable. 

 Fifth, it is a useful tool for working out 

 unknown cellular patterns which may 

 support clinical diagnoses of other 

 nasal and sinus conditions. 



For cytological studies, nasal secre- 

 tion is collected, after blowing the nose, 

 on wax paper or on a cellophane hand- 

 kerchief. Specimens are preferably 

 taken separately from each side of the 

 nose. The material may also be blown 

 directly on to a clean glass slide, then 

 gently smeared with a probe (not a dry 

 cotton applicator). Thin smears are 

 more suitable for microscopic study 

 than thick ones. In order to obtain a 

 sampling from a normal nose, the naso- 

 pharynx is wiped with a small cotton 

 applicator, slightly moistened with 

 saline. For abnormal dry noses, the 

 raping technique may also be used be- 

 fore application of any drugs. A saline 

 tampon, inserted into the nostril, may 

 stimulate the flow of secretion in order 

 to obtain a specimen. Secretions from 

 the sinuses may be collected by aspira- 

 tion of the nose, displacement or irri- 

 gation of sinuses, or be taken directly 

 from the area during an operation. 

 These secretions, direct from the re- 

 spective paranasal sinuses, are often of 

 value in locating the source of the in- 

 fection and in determining the type 

 of cellular response. They thus help 

 to complete the diagnosis. The cyto- 

 logical picture presented in the nose 

 may be somewhat different from the 

 cellular pattern observed when the ma- 

 terial is obtained directly from a par- 

 ticular sinus. Both should be studied 

 and correlated whenever possible. 



In the differential diagnosis of acute 

 and chronic infections from allergic 

 ones, or in demonstrating the joint ex- 

 istence of both, the numerical propor- 

 tions of eosinophilic to neutrophilic 

 cells in the nasal smear should be eval- 

 uated. The ratio is usually an expres- 

 sion of the nature and stage of the nasal 



