Assessment of mucociliary transport in patients with chronic mucoid rhinitis

Chronic rhinitis is the manifestation of a heterogeneous group of disease e ntities and often proves difficult to manage successfully. We present the i nvestigations of the mucociliary system in 40 patients with mucoid rhinorrh oea as their principal symptom of whom 20 had pan respiratory disease. The saccharin clearance time (SCT) was measured and classified as normal if it was below 20 min. Objective measurement of clearance was made using (99m)Te chnetium-labelled human serum albumin (Tc-99m-WSA). We have standardized ou r method using a micrometer syringe driver to produce a droplet of consiste nt size (droplet size, 0.01 ml, SD 0.0002 ml) that reduces the dose of radi ation. The movement of the droplet was measured over 20 min (RLT). The mean , maximum rate and percentage moved were calculated. Patients were divided into those who had chest disease (20) and those without and a chi(2)-test w as performed for the mean RLT time between the two groups. There was a stro ng correlation between mean and maximum rates (r = 0.91). One patient has a normal SCT and normal RLT. Patients with chest disease had a significantly lower mean RLT (P > 0.01). Assuming that RLT is the standard investigation , six patients were normal but had an abnormal SCT, this is a false positiv e error of 15%. The false negative error was 4/40 (10%). The association be tween sinus and chest disease with abnormal mucociliary clearance is stress ed.