Random ciliary orientation has recently been proposed as a variant of
primary ciliary dyskinesia. We report a 12 year old boy with all the f
eatures of primary ciliary dyskinesia and absent nasal mucociliary cle
arance in whom repeated biopsies of the nasal epithelium showed normal
ciliary beat frequency. The only abnormality discovered was disorient
ation of the central microtubules of his cilia.