Saccharin test of maxillary sinus mucociliary function after endoscopic sinus surgery

Objectives: To determine the usefulness of the saccharin time (ST) test for evaluating the mucociliary function of the maxillary sinus after endoscopi c sinus surgery (ESS) for chronic sinusitis. Study Design: Methods: This st udy was conducted on 88 maxillary sinuses of 74 patients after ESS. The max illary sinus fontanel was broadly opened via the middle meatus using an end oscope, and a saccharin granule was adhered to the bottom of the maxillary sinus mucosa. The time until the patient recognized the sweet taste was rec orded. Before the ST test, the bilateral maxillary sinuses were classified into the following four groups on the basis of the post-ESS severity of muc osal edema and swelling as revealed by endoscopic observation: normal (45 s inuses), mild mucosal edema and swelling (24), moderate mucosal finding (14 ), and severe mucosal finding or filling of the sinus with a polyp(s) (5). Results: The mean ST values in the normal group and the groups with mild, m oderate, and severe mucosal edema and swelling were 35.7, 38.1, 63.6, and 8 8.0 minutes, respectively. Thus the ST increased with the post-ESS severity of the mucosal lesion. However, for the group with mild mucosal edema and swelling, scanning electron microscopic observation of three maxillary sinu ses in which the ST exceeded 120 minutes and four sinuses in which the ST w as 40 minutes revealed extensive cilia loss in the former sinuses, but not in the latter. A second post-ESS endoscopic observation was performed in 17 patients, revealing improvement in 11 sinuses, no change in 5 sinuses, and aggravation in 1 sinus (compared with the initial test). The ST test was a lso repeated, revealing that the ST became shorter in most of the endoscopi cally improved sinus group. However, a few sinuses showed a discrepancy bet ween the change in the endoscopic findings and the ciliary function (ST). C onclusion: Measurement of the maxillary sinus ST is a simple, accurate, and useful technique for assessing the post-ESS mucociliary function in conjun ction with endoscopy, and the information gained can help in deciding subse quent therapy.