ENDONASAL SINUS SURGERY IMPROVES MUCOCILIARY TRANSPORT IN SEVERE CHRONIC SINUSITIS

A total of 22 patients with extensive chronic sinusitis were examined before and 7.2 +/- 1.1 months after microscopic endonasal sinus surger y. Pre-and postoperative nasal mucociliary transport was measured usin g a modified saccharine test and ciliary beat frequency of nasal respi ratory cells using video interference contrast microscopy. In patients suffering from chronic sinusitis, nasal ciliary beat frequency was si gnificantly lower (8.0 +/- 1.8 Hz) than in normals (9.5 +/- 1.7 Hz, p < 0.02). Following endonasal sinus surgery, ciliary beat frequency in patients with chronic sinusitis remained reduced (8.3 +/- 1.2 Hz). Nas al mucociliary transport time was significantly (p < 0.05) longer (20. 9 +/- 9.4 minutes) in patients with chronic sinusitis than in normals (14.9 +/- 8.4 minutes). Nasal mucociliary transport improved significa ntly (p < 0.05) to 13.8 +/- 8.4 minutes in 17 of 22 patients without r ecurrent sinusitis and remained prolonged (20.6 +/- 7.7 minutes) in 5 of 22 patients with recurrent disease. These data suggest that ciliary beat frequency of nasal respiratory cells and nasal mucus transport a re impaired in patients suffering from chronic sinusitis. After micros copic endonasal sinus surgery, impaired mucociliary transport is impro ved, and ciliary beat frequency remains lower than in normals.