Assessment of Local Mucociliary Clearance of the Middle Nasal Meatus After Different Types of Surgical Access to the Maxillary Sinus

Abstract

Abstract. The paper considers an original method for asessment the ciliar beating frequency (CBF) of the ciliated epithelium (mucociliary clearance) of the nasal mucosa using modern high-speed digital video recording of the microscopic picture of the brushed specimen, which followed by mathematical processing. This method used to study the local mucociliary clearance of the middle nasal meatus, which plays a key role in the modern understanding of the osteomeatal complex function. The normal values of the CBF of the middle nasal meatus in healthy individuals (11.76 ± 3.01 Hz) were determined. We studied the changes in the CBF of the ciliary epithelium of the middle nasal meatus with foreign bodies of the maxillary sinus. A correlation found between changes in the CBF of the ciliary epithelium of the middle nasal meatus and the CT changes in the region of the middle nasal meatus and paranasal sinuses. This also determined the effect of surgical trauma on the CBF of the middle nasal meatus and its changes in the early (up to 1 month) and late (1-6 months) following period. We clearly proved the dependence of the mucociliary clearance of the middle nasal meatus on the type of surgical access to the maxillary sinus during surgical interventions for foreign bodies of the maxillary sinus. We revealed certain advantages of transmaxillary and prelacrimal surgical access to the maxillary sinus over endonasal antrostomy during surgical interventions for foreign bodies of the maxillary sinus. Our data allow optimizing surgical interventions on the maxillary sinus with minimization of surgical trauma to the ciliary epithelium of the middle nasal passage and improving the functional and morphological results of surgical treatment of foreign bodies in the maxillary sinuses.