비내시경 수술 전후에 있어서 상악동 내의 점액섬모 수송기능에 관한 연구

Abstract

Background and Objectives: Mucociliary clearance of the nasal cavity is an important defence mechanism of the body. In chronic paranasal sinusitis, the mucociliary flow is markedly decreased, but after endoscopic sinus surgery (ESS), it is known to be improved. But it is not clearly known whether the result of ESS contributes to the change of the mucociliary function in the maxillary sinus. Thus we aimed to observe the change of mucociliary transport time before and after ESS. Materials and Method: We measured saccharin transit time (STT) of maxillary sinus in 82 patients with chronic paranasal sinusitis before and after ESS from June, 1997 to April, 1998. The control group is defined as chronic hypertrophic rhinitis or nasal septal deviation without paranasal sinusitis. Preoperatively, saccharin was introduced into the antral cavity through the puncture needle via the inferior meatus and then STT was checked. Postoperatively, saccharin was introduced into the antral cavity through the antrum suction tip via the widen ostium and then STT was checked. With nasal polyp, nasal discharge, allergy and radiologic finding, all patient groups were divided into two groups each. All patients had postoperative 1st, 2nd, 4th, 8th, 12th, 16th, 20th, 24th, 28th and 50th week assessments. Results: STT was normalized by the end of 12th week. STT was influenced by the presence of nasal discharge or severity of radiologic finding but not by the presence of allergy or nasal polyp. Conclusion: In saccharin test, maxillary sinus is a more meaningful site than nasal septum or inferior turbinate. Restoration of mucociliary function takes 3 months and was not influenced by the presence of allergy or nasal polyp after ESS. Therefore pre-operative profiles and endoscopic findings during surgery can serve as a reference of recovery time and treatment modality. (J Clinical Otolaryngol 2001;12:222-228)