Treatment of orbicularis oculi muscle hypertrophy in lower lid blepharoplasty

Curschmann's spirals have been observed for more than 100 yr in the sputum of patients affected by lung cancer, asthma, chronic bronchitis, or in asymptomatic smokers. However, to date, their clinical significance and pathogenesis have not been completely explained. Curschmann's spirals in the sputum of two populations were studied: 164 traffic policemen of Rome and 119 subjects living in a rural district near Perugia. Of these two groups, only the first were exposed daily to urban environmental pollutions. Spirals were detected in the sputum of 29 traffic policemen and in 3 subjects from the group not exposed daily to urban environmental pollutants. Between these two groups of subjects the difference was statistically significant (P < 0.001). Therefore, daily exposure to urban atmospheric pollution may play a role in the production of Curschmann's spirals. Our two groups were also divided into smokers and nonsmokers to evaluate if cigarette smoking could influence the presence of spirals in sputum. Our study confirms the association of spirals in the sputum of smokers but also indicates their presence in individuals who never smoked but were exposed to environmental pollutants. We also noticed that exposure to pollution and cigarette smoking may have a synergistic effect on the formation of spirals in the respiratory tract.