The effect of endoscopic sinus surgery on mucociliary clearance in patients with chronic sinusitis

Abstract

The saccharin test was used to measure mucociliary clearance in 50 patients with symptoms of chronic sinusitis. Samples of the nasal mucosa were also examined under transmission electron microscopy before and after functional endoscopic sinus surgery (FESS). Before surgery, the mean saccharin clearance (ST) was 37.0 +/- 15.7 min, with nasal mucosa exhibiting ciliary loss as well as other ultrastructural changes. Three months after surgery, the mean ST had improved to 20.3 +/- 7.5 min and significant regeneration of cilia was observed. It was therefore concluded that FESS had successfully corrected mucociliary dysfunction in these patients.

Role of measurement of nasal mucociliary clearance by saccharine test as a yard stick of success of functional endoscopic sinus surgery

“…reported reduction in saccharine clearance time after FESS [24]. Several other studies have reported improvement in saccharine clearance time after FESS [8,10,[16][17][18][19][20][21]. Measurement of NMCT by saccharine method can be easily performed, is free from observer variations, has no side-effects, cheap, simple to carryout and requires no elaborate equipments.…”

Host-microbial interactions in patients with chronic rhinosinusitis

“…62 Several studies have established that CRS is associated with an acquired reduction in mucociliary clearance. [63][64][65][66][67] Mucociliary clearance typically normalizes after clearance of infection and restoration of normal sinus drainage. 63,65,66 This has been confirmed by in vitro studies showing that sinonasal mucosal explants from patients with CRS show blunted ciliary beat frequency responses to cholinergic and adrenergic stimulation but normal responses within 36 hours of culturing.…”

“…[63][64][65][66][67] Mucociliary clearance typically normalizes after clearance of infection and restoration of normal sinus drainage. 63,65,66 This has been confirmed by in vitro studies showing that sinonasal mucosal explants from patients with CRS show blunted ciliary beat frequency responses to cholinergic and adrenergic stimulation but normal responses within 36 hours of culturing. 68 Lai et al 69 reported increased expression of the centrosomal protein 110 (Cp110) in inflamed sinus tissue from patients with CRS.…”

Mucociliary Function: Its Variations with Disease

“…In the statistics reviewed, [1][2][3][5][6][7][8][9][10] we found that the sample sizes varied from a minimum of 20 to a maximum of 50. Hence, we (based on feasibility) studied a total of 32 subjects in each of the groups (chronic rhinosinusitis, smokers, and controls); a total of 96 subjects were studied.…”

“…2 By contrast, this finding is not present in merely objective pathologies, such as hypertrophic rhinitis or DNS. 1 Elwany et al 7 suggested that the small space between the middle turbinate and the lateral wall of the nose, when exposed to minimal mucosal swelling, can bring opposing mucosal areas into contact, thus impeding their ciliary activity. Increased proteases released by inflammatory mediators contribute to the ciliary damage or loss.…”