THE ROLE OF MUCOUS SECRETION ON NASAL MUCOCILIARY TRANSPORT IN CHRONIC SINUSITIS

Abstract

Chronic sinusitis is one of the most prevalent nasal diseases in Japan. Muco-purulent nasal discharge is the major symptom of this disease. Nasal mucociliary clearance was measured both in healthy subjects and the patients with chronic sinusitis. A method with saccharin granule was used for the measurement of mucociliary transit time (ST). Nasal mucociliary clearance in chronic sinusitis was significantly decelerated in comparison to the control (p<0.005).
Nasal secretions (mucus) were collected from nasal cavity by aspiration both in patients and healthy controls. Each sample of nasal discharges was used for in vitro bulfrog palate clearance studies and the results were compared to the nasal mucociliary clearance. Mucociliary transport rate on mucus depleted frog palate (MTR on frog palate) was 12.5±2.5mm/min in mucus of the control and 6.1±1.5mm/min in mucus of chronic sinusitis. This differaence was statistic-ally significant (p<0.005). The MTR on frog palate in the patients whose nasal ST were within normal range was significantly lower than that in controls (p<0.005), but was not significantly different from MTR on frog palate in the patients whose nasal ST were over the normal range. These results suggest that properties of nasal mucus which decreased mucociliary clearance on frog palate did not contribute to the nasal mucociliary clearance of the patients with chronic sinusitis.
The correlation between MTR on frog palate and nasal ST was not statistically significant in both controls and the patients with chronic sinusitis.
In chronic sinusitis, decelerated nasal ST improved significantly by the administration of physiological saline with nasal nebulizer in comparison to the nasal ST before the administr-ation (p<0.01). No significant change of nasal ST was observed in controls before and after the nebulization.
The decelerated mucociliary clearance thus depends on properties of the nasal mucus in parts, and depends largely on the factors which exist only in nasal cavities in vivo. These in vivo factors will be affected by administration of physiological saline by nebulizer.