Nasal Mucociliary Transport Rate Research Articles

Nasal mucociliary clearance after extremely low frequency by scintigraphic and histopathologic evaluation.

To investigate the effect of exposure to extremely low-frequency magnetic fields (ELF-MFs) on nasal mucociliary clearance (MCC) by rhinosintigrapic and histopathological evaluation. The rats were separated into three groups according to ELF-MFs intensity and control group. The exposure groups were standardized for the ELF-MFs of 1, 1.5, and 2 mT emitted by 3 Helmholtz coils for 4 h/day for 30 days. Rhinoscintigraphy was performed to measure nasal MCC. The nasal tissues were examined for edema, inflammation, hyperemia, necrosis, ciliary loss, goblet cell density, and fibroblast proliferation. The data were evaluated statistically (p < 0.05). Nasal mucociliary clearance rates (NMCR) were calculated as 33.13 ± 5.91% in control, 27.78 ± 4.7% in 1 mT, 22.67 ± 5.43% in 1.5 mT, and 18.11 ± 6.33% in 2 mT. NMCR were decreased with increasing ELF-MFs, in 1.5 and 2 mT groups (p < 0.05) compared to control. Nasal mucociliary transport rate (NMTR) values were found to be 2.17 ± 0.33 mm/min in control, 1.82 ± 0.32 mm/min in 1 mT, 1.46 ± 0.34 mm/min in 1.5 mT and 1.24 ± 0.29 mm/min in 2 mT. NMTR was decreased in the groups exposed to 1.5 and 2 mT (p < 0.05) compared to control. The edema, hyperemia, inflammation, ciliary loss, and goblet cell density were statistically significant differences between control and groups exposed to 1.5 and 2 mT (p < 0.05). Our rat model has shown nasal mucosa damage and decreased NMCR and NMTR by rhinoscintigraphy as ELF-MFs intensity increases. It may be detrimental to nasal mucosa mucociliary function depending on the ELF-MFs intensity. N/A Laryngoscope, 133:2081-2089, 2023.

The Efficacy of Functional Endoscopic Sinus Surgery Combined With Triamcinolone Acetonide Aqueous Nasal Spray for the Treatment of Chronic Rhinosinusitis.

ObjectiveWe aimed to investigate the efficacy of functional endoscopic sinus surgery (FESS) combined with triamcinolone acetonide aqueous nasal spray (TAA AQ) for the treatment of chronic rhinosinusitis.MethodsFrom December 2019 to June 2021, 109 patients with chronic rhinosinusitis were classified into a control group (n = 50) and an experimental group (n = 59) according to the method of treatment. Subjects in the control group were treated with FESS while those in the experimental group were treated with FESS + TAA AQ. We then compared clinical indices, total effective rate, and the clinical symptoms of patients between the two groups. The pre- and postoperative serum levels of inflammatory cytokines were also determined. Before and 12 months after surgery, we analyzed the recovery of the nasal mucosa, olfactory function, and mucociliary transport rate of each patient. Postoperative complications were observed and recorded and the quality-of-life 12 months after surgery was ascertained.ResultsClinical indices and total effective rate were higher in the experimental group. After treatment, the VAS score and serum levels of inflammatory cytokines in the two groups both decreased, although the experimental group had lower VAS scores and inflammatory cytokine levels. Six months after treatment, olfactory function, and the recovery of nasal mucosa were improved, MTR had increased, and the total incidence of complications had reduced in the experimental group when compared with the control group. No significant difference was found between the two groups in terms of quality-of-life (P > 0.05).ConclusionThe combination of FESS and TAA AQ exerted a certain therapeutic effect on chronic rhinosinusitis.

Evaluation of Mucociliary Clearance by Three Dimension Micro-CT-SPECT in Guinea Pig: Role of Bitter Taste Agonists.

Different image techniques have been used to analyze mucociliary clearance (MCC) in humans, but current small animal MCC analysis using in vivo imaging has not been well defined. Bitter taste receptor (T2R) agonists increase ciliary beat frequency (CBF) and cause bronchodilation but their effects in vivo are not well understood. This work analyzes in vivo nasal and bronchial MCC in guinea pig animals using three dimension (3D) micro-CT-SPECT images and evaluates the effect of T2R agonists. Intranasal macroaggreggates of albumin-Technetium 99 metastable (MAA-Tc99m) and lung nebulized Tc99m albumin nanocolloids were used to analyze the effect of T2R agonists on nasal and bronchial MCC respectively, using 3D micro-CT-SPECT in guinea pig. MAA-Tc99m showed a nasal mucociliary transport rate of 0.36 mm/min that was increased in presence of T2R agonist to 0.66 mm/min. Tc99m albumin nanocolloids were homogeneously distributed in the lung of guinea pig and cleared with time-dependence through the bronchi and trachea of guinea pig. T2R agonist increased bronchial MCC of Tc99m albumin nanocolloids. T2R agonists increased CBF in human nasal ciliated cells in vitro and induced bronchodilation in human bronchi ex vivo. In summary, T2R agonists increase MCC in vivo as assessed by 3D micro-CT-SPECT analysis.

Evaluation of nasal mucociliary transport rate according to nasal septum deviation type.

Nasal septum deviation (NSD) may affect mucociliary activity (MCA) to varying degrees, depending upon the severity of the deviation. We used rhinoscintigraphy to determine the impact of the various NSD types on MCA. A recent classification describing 6 different forms of NSD was used to standardize the study. Forty-eight subjects were enrolled. Eight patients for each form of NSD were accrued for further study. Rhinoscintigraphy was performed using technetium 99m macroaggregated albumin ((99m) Tc-MAA) before and 3 months after surgery. Nasal mucociliary transport rate (NMTR), the half-time of (99m) Tc-MAA activity, and clearance rate over a 20-minute period were compared between groups. Preoperative NMTR and clearance rates were significantly lower and half-time was significantly longer in types 4 and 6 than in the other groups. Although the postoperative NMTR and clearance rates increased compared with preoperative values in all groups, the increase was significant only in types 2, 4, and 6. The postoperative half-time increased significantly compared with the preoperative values in types 2, 4, and 6. The postoperative rhinoscintigraphy evaluation revealed no significant differences among groups in NMTR, half-time, or clearance rate. NSD types 4 and 6 had lower preoperative NMTR and clearance rates and a longer half-time compared with the other groups. However, the postoperative values of these parameters were not significantly different among groups. Our results indicate that NSD types 4 and 6 had the greatest impact on MCA, suggesting that these patients may receive the maximum benefit from septoplasty.

Assessment of technetium-99m labeled macroaggregated albumin rhinoscintigraphy for the measurement of nasal mucociliary transport rate: intratest, interobserver, and intraobserver reproducibility.

Objectives. The measurement of mucociliary transport velocity by rhinoscintigraphy with Tc-99m-macroaggregated albumin (99mTc-MAA) is reliable measure of mucociliary clearance. The aim of this study is to assess the intratest, interobserver, and intraobserver reproducibility of nasal mucociliary transport rate (NMTR) measurement. Materials and Methods. Twenty-two subjects were evaluated to determine intratest reproducibility and a group of 35 subjects was examined to determine inter- and intraobserver reproducibility. Rhinoscintigraphy with 99mTc-MAA was used to measure NMTR in all study subjects. Paired NMTR measurements were compared using a range of statistical methodologies. Intraclass correlation coefficients (ICC) and repeatability coefficients and Bland-Altman plots were applied to assess the degree of intratest, interobserver, and intraobserver variation. Results. Statistical analysis of test and retest experiments demonstrated the statistical equivalence of intratest NMTR measurements, interobserver NMTR measurements, and intraobserver NMTR measurements. The intratest ICC, interobserver ICC, and intraobserver ICC were 0.96, 0.83, and 0.91, respectively, indicating that intratest and intraobserver reproducibility are excellent and interobserver reproducibility is good. Conclusions. Rhinoscintigraphy using 99mTc-MAA results in highly reproducible measurement of NMTR. The use of radionuclide imaging in measuring NMTR results in excellent intratest and intraobserver reproducibility and good interobserver reliability.

The effect of high altitude on olfactory functions

It is known that high-altitude trips cause nasal congestion, impaired nasal mucociliary transport rate, and increased nasal resistance, due to decreased partial oxygen pressure and dry air. It is also known that olfactory perception is affected by barometric pressure and humidity. The aim of the present study was to investigate whether olfactory function changes in relation to high altitude in a natural setting. The present study included 41 volunteers with no history of chronic rhinosinusitis or nasal polyposis. The study group consisted of 31 men (76 %) and 10 women (24 %); the mean age of the study population was 38 ± 10 years. Olfactory testing was conducted using "Sniffin' Sticks" at a high altitude (2,200 ms) and at sea level. Odor test scores for threshold and identification were significantly better at sea level than at high altitude (p < 0.001). The major finding of this investigation was that olfactory functions are decreased at high altitudes.

Evaluation of Nasal Mucociliary Transport Rate by99mTc-Macroaggregated Albumin Rhinoscintigraphy in Woodworkers

Woodworkers in the furniture industry are exposed to wood dust in their workplaces. The aim of this study is to investigate the effect of occupational wood dust exposure on the nasal mucociliary transport rates (NMTRs) in woodworkers. Twenty five woodworkers and 30 healthy controls were included in this study. Wood dust concentration in workplaces was measured using the sampling device. 99m Tc-macroaggregated albumin (99mTc-MAA) rhinoscintigraphy was performed, and NMTR was calculated in all cases. In statistical analysis, an independent samples t-test was used to compare NMTR of woodworkers and control subjects. We found that the mean NMTR of the woodworkers was lower than that of the healthy controls. However, there was not a statistically significant difference between them (P = 0.066). In conclusion, our findings suggested that wood dust exposure may not impair nasal mucociliary transport rate in woodworkers employed in joinery workshops.

Evaluation of the nasal mucociliary transport rate by rhinoscintigraphy in marble workshop workers

Marble workers are occupationally exposed to intense environmental marble dust in their workplace. We aimed to investigate the effect of occupational marble dust exposure on nasal mucociliary transport rate (NMTR). Seventeen marble workers and 18 healthy controls were studied. In all subjects, NMTRs were measured by (99m)Tc-MAA rhinoscintigraphy. NMTRs of workers and control groups were compared by statistically. Mean NMTR was found as 9 ± 1.8 mm/min in marble workers whereas mean NMTR of healthy controls was 9.6 ± 2.2 mm/min. There was no statistically significant difference between NMTRs of workers and control groups (p > 0.05). This study has shown that occupationally exposured marble dusts may not cause functional impairment on NMTR in marble workshop workers.

Evaluation of the nasal mucociliary transport rate by rhinoscintigraphy before and after surgery in patients with deviated nasal septum

In this study, we have investigated the effect of nasal septal deviation (NSD) on nasal mucociliary activity and how does a septoplasty operation affecs the nasal mucociliary transport rate in the first and third months during the post-operative period. Twenty-two patients who were diagnosed with NSD and 22 healthy controls were studied using rhinoscintigraphy with Tc-99m-macroaggregated albumin (Tc-99m-MAA). On each case, the nasal mucociliary transport rate (NMTR) was measured pre-operatively only on five cases, on the first and third months of post-operative period. The NMTRs of patients with a deviated septum were significantly lower than the NMTRs of the healthy controls on both the convex and concave sides. Significant improvement was observed in the first post-operative month. On the concave and convex sides, the average postop third month post-operative NMTR value was higher than the first month post-operative NMTR values. It was concluded that the septoplasty operation improves reduced NMTRs after surgery. The effect of nasal surgery on nasal mucociliary activity may be more accurately evaluated in the third month than the first month of post-operative period.

Long-term follow-up of the clinical relevance of short outer dynein arms in human nasal cilia.

Clinical significance of short outer dynein arms was examined in a long-term follow-up study of 76 patients with various respiratory symptoms. Clinical evaluations, nasal mucociliary transport rate (NMTR) measurement and transmission electron microscopy were performed. Follow-up examinations took place 5-11 years later. In the initial examination four patients and on follow-up seven patients were found to have short outer dynein arms in their nasal mucosal biopsies. Short dynein arms were associated with a slow NMTR, poorly coordinated ciliary beat direction, and clinical symptoms of perennial rhinitis and recurrent sinusitis. Short dynein arms were found to be a significant histologic finding and probably represent a variant of primary ciliary dyskinesia. In some cases short outer dynein arms may be a reversible finding with improving clinical symptoms. It is obvious that at least part of dynein defects are acquired.

Clinical Relevance of Tubulus Anomalies and Compound Cilia

Transmission electron microscopy (TEM) from nasal mucosa and nasal mucociliary transport rate (MTR) with a radio-isotopic method were examined in 144 patients with various respiratory symptoms. Examinations were not performed during acute infections. In cases of increased amount of tubulus anomalies: nasal MTR was not significantly slower than in other patients, the disorientation of ciliary beat direction was significantly larger, there was no connection with increased amount of compound cilia and there was no correlation to any specific symptom or respiratory disease. In cases of increased amount of compound cilia: nasal MTR did not differ from other patients and the disorientation of ciliary beat direction did not differ from other patients. In a follow- up study of 76 patients 5–11 years (mean 9.3 years) later the amount of tubulus anomalies and compound cilia had changed in most patients. In patients with less symptoms at the follow-up than primarily, there was a non-significant tendency to have less tubulus anomalies, too, but no change in the amount of compound cilia. The amount of tubulus anomalies and compound cilia is not stable. Their number can either increase or decrease during a follow-up. Tubulus anomalies are non- specific and probably secondary changes of minor clinical importance and compound cilia would seem to be quite irrelevant findings in the ultrastructural evaluation of respiratory cilia.

Asymmetry in the nasal mucociliary transport rate.

Several methods have been devised for measuring the nasal mucociliary transport rate (N-MTR), but only one side of the nose has usually been studied. This study was conducted to determine whether there are side-to-side differences in N-MTR. A radioisotopic method was used to investigate 185 patients with various respiratory symptoms. Bilateral measurements were performed in the 111 patients with an N-MTR of under 7 mm per minute. In 16 healthy control subjects, the N-MTR ranged from 5.0 to 14.6 mm per minute (mean: 7.8 mm per minute) in the better nostril and from 1.2 to 11.0 mm per minute (4.3 mm per minute) in the poorer nostril (P<.001). In the 111 patients, the N-MTR ranged from 0.0 to 12.0 mm per minute (3.5 mm per minute) in the better nostril and from 0.0 to 9.5 mm per minute (1.7 mm per minute) in the poorer nostril (P<.001). In the control subjects, the mean N-MTR was better (P=.011) in the decongested nostril. Even when the N-MTR was less than 5 mm per minute on the first measured side, it was normal on the opposite side in 18.9% of patients and in 18.8% of control subjects. The author concluded that if the N-MTR is impaired in one nostril, it should also be measured in the opposite nostril.

The correlation of mucociliary transport and scanning electron microscopy of nasal mucosa.

The ciliary ultrastructure studied by scanning electron microscopy (SEM), nasal mucociliary transport rate (MTR) measured by a radioisotopic method and their correlation with each other were studied in 56 patients with recurrent or chronic respiratory infections. Patients were divided into three groups according to MTR. The number of pathological SEM findings increased remarkably in groups with moderate or poor MTR. Loss of ciliated cells and microvilli were seen in 86% of specimens with poor MTR, in 71% with moderate MTR, and in 50% with good MTR. There was ciliary disorientation in 45% of cases with poor MTR compared with 25% in cases with good MTR. Epithelial metaplasia and the number of short cilia increased in groups with poor or moderate MTR.

Ciliary Ultrastructure and Mucociliary Transport in Upper Respiratory Tract Infections

The ciliary ultrastructure in transmission electron microscopy and nasal mucociliary transport rate (MTR) by a radioisotopic method were studied in 50 patients with longstanding upper respiratory tract infections. The clinical symptoms correlated well with MTR. The symptoms in patients with MTR 3 mm/min or better were mild, but the patients with poor MTR (less than 3 mm/min) suffered from recurrent or severe infections. The completely normal ultrastructural findings were found only in patients with MTR better than 3 mm/min. All the patients with poor MTR had pathological ciliary ultrastructure, with numerous tubular anomalies and disorientation of ciliary beat direction. The outer dynein arms were found to be short in 16% of cases with poor MTR.