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Background Chronic recurrent sinusitis (CRS) is one of the most common chronic conditions in the United States. There is a significant subpopulation of CRS patients who remain resistant to cure despite rigorous treatment regimens including surgery, allergy therapy and prolonged antibiotic therapy. Antimicrobial photodynamic therapy (aPDT) is a non-invasive non-antibiotic broad spectrum antimicrobial treatment. Our previous in vitro studies demonstrated that aPDT reduced CRS polymicrobial biofilm and planktonic bacteria and fungi by >99.9% after a single treatment. Prior to human treatment however, aPDT treatment must be demonstrated to not result in histologic damage to the sinus ciliated respiratory epithelium. The objective of this study was to demonstrate the safety of aPDT treatment on a living human ciliated respiratory mucosal model (EpiAirway™). Methods A study of aPDT treatment of EpiAirway™ was performed. Treatment groups included a non-treatment control, laser light alone, photosensitizer alone and therapeutic photosensitizer and light combination (aPDT). At completion of treatment, the EpiAirway™ tissue was fixed in 10% formalin, paraffin-embedded, sectioned, H &E stained and mounted. All samples were blinded and microscopically examined by a human pathologist to assess any effect of aPDT on the tissue, cilia or mucosal glands. The results were correlated with the treatment parameters. Results The EpiAirway™ histologic study demonstrated no histologic alteration of the respiratory cilia or mucosal epithelium in any of the treatment groups. Conclusions aPDT is a safe treatment for CRS resulting in no histologic alteration of human ciliated respiratory mucosa as is found in the human sinuses.

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The case is a 56-year-old woman who presented with cord compression from a lesion of the thoracic spine. Histologic analysis confirmed the diagnosis of a spindle cell sarcoma. Ultrastructural analysis showed features characteristic of a leiomyosarcoma. Subsequent discussion with the patient revealed a history of hysterectomy performed for fibroid uterus 5 years before the current presentation. Review of the previous surgical specimen confirmed the presence of a leiomyosarcoma originally interpreted as a large infarcted myoma.