Patency of the maxillary sinus ostium in healthy individuals

In a group of 20 healthy subjects the patency of the maxillary ostium has been evaluated in 35 maxillary sinuses with three different techniques: simultaneous pressure recording in the sinus and the ipsi- and contralateral nasal cavity; simultaneous recording of differential pressure between the sinus and the ipsilateral nasal cavity and air-flow through the ostium during nasal breathing; recording of the pressure rise in the sinus with an artificial air-flow of 1 litre per minute applied to the sinus. The tests were carried out in sitting and recumbent positions. In 5 persons (10 sinuses) a retest was performed after 2 months. These subjects were also tested with an inflatable neck cuff in order to obtain an increased venous pressure. Rhinomanometry at rest and after physical effort was also performed. The pressure relationship between the maxillary sinus and the ipsilateral nasal cavity was 1:1 in both the sitting and the recumbent position, but less than 1 when the contralateral nasal cavity was measured. Pressure recording alone gives no quantitative information about the patency of the ostium. Determination of the ostial resistance during nasal breathing could be performed in 13 sinuses, but in the remaining 22 the ostia were too wide to give a measurable resistance. The equivalent ostial diameter during inspiration could be estimated in 12 of the sinuses from a diagram constructed from known ostial diameters in model experiments. With an artificial air-flow applied into the sinus, the equivalent ostial diameters could be estimated from the diagram in all cases. No statistical difference was found in comparable cases between the mean equivalent ostial diameters estimated with the two methods. The equivalent ostial diameters showed a statistically significant reduction in the recumbent position and after application of the neck cuff. A statistically significant relationship was also found between the airway resistance of the nasal cavity and the equivalent diameter of the ostium in sitting and recumbent positions. Such a relationship could not be found between the equivalent ostial diameters measured at rest and the nasal resistance recorded after physical effort.     

Chronic bacterial rhinosinusitis: description of a mouse model

OBJECTIVES: To survey normal murine sinonasal anatomy and to create a mouse model for chronic bacterial rhinosinusitis. DESIGN: Anatomic, histologic, and pathophysiologic study displaying normal murine sinonasal anatomy and surgically created unilateral sinonasal inflammation. SUBJECTS: Twenty-one 6-week-old, male C57BL/6 mice. INTERVENTIONS: Animals that underwent unilateral maxillary sinus ostial obstruction using Merocel nasal packing, animals with unilateral Bacteroides fragilis inoculation alone, and animals with both ostial obstruction and bacterial inoculation were examined at 4 weeks for histologic evidence of chronic sinonasal inflammation. Experimental interventions were compared with contralateral control sinuses within each animal and with normal and sham-operated controls. RESULTS: Normal mouse paranasal sinuses include maxillary sinuses, ethmoid air cells, and respiratory-type epithelium. In experimental animals, the lateral maxillary sinus wall, nasal septum, and superior turbinelle of the maxillary sinus were examined histologically. Epithelial thickening and disarray, goblet cell hyperplasia, inflammatory infiltrates, and sinonasal fibrosis were present in the experimental sinuses of animals packed with Merocel alone or Merocel with bacterial inoculation. Changes seen with Merocel and bacteria were more dramatic than those with Merocel alone. Sham-operated controls and sinuses inoculated with bacteria alone did not differ significantly from the sinuses of normal animals. CONCLUSION: Unilateral maxillary sinus ostial obstruction using Merocel nasal packing along with B fragilis inoculation results in a persistent, localized bacterial rhinosinusitis in mice.     

Effects of long-term induced ostial obstruction in the rabbit maxillary sinus

One of the widely proposed theories for mucocele formation is sinus ostial obstruction. Accordingly, this study was undertaken to investigate the long-term effects of ostial obstruction in the rabbit maxillary sinus and its potential role in the pathogenesis of mucoceles. Maxillary sinus ostial obstruction was induced on one side in eight Pasteurella-free White New Zealand rabbits using Histoacryl. The rabbits were housed in a Pasteurella-free zone for 24 weeks. At re-exploration, only three of the eight maxillary sinuses where ostial obstruction was induced showed pressure recording consistent with ostial obstruction. Mucociliary clearance activity was assessed using India ink. Swabs for culture were taken from the infected maxillary sinuses. Mucosal specimens for histopathological examination were harvested from one of the maxillary sinuses with obstructed ostium as well as from another sinus with nonobstructed ostium. The three maxillary sinuses with obstructed ostia showed gross evidence of infection and deranged mucociliary clearance, but no mucocele formation. Based on the findings of this study it is concluded that long-term ostial obstruction indeed plays a role in the pathogenesis of chronic sinusitis, but it did not induce mucocele formation in the rabbit maxillary sinus.     

Pressure measurements in the normal and occluded rabbit maxillary sinus

Occlusion of the maxillary ostium is considered to be a key factor in the pathogenesis of maxillary sinusitis. In this study, the authors determined the effect of ostial occlusion on pressure in the rabbit maxillary sinus which, like most humans, has only one ostium. We compared pressures in the normal and occluded maxillary sinus and the nasal cavity during spontaneous breathing in anesthetized adult animals. Serial pressure measurements were obtained from sinuses with patent ostia in nasal-breathing rabbits and with occluded ostia in both nasal-breathing and tracheotomized animals. Sinuses with patent ostia showed pressure curves synchronous with the respiratory cycle. Inspiratory and expiratory pressures in the nasal cavity and the sinus were isobaric. Sinuses with occluded ostia initially developed a positive pressure followed by a negative pressure that reached a subatmospheric plateau of-28.2 ± 7.3 mm H₂O (mean ± standard deviation [SD]) within 20 to 50 minutes. This is the first quantitative study of sinus pressures using the rabbit as an animal model. The findings may contribute to a better understanding of the role of ostial occlusion in the pathogenesis of maxillary sinusitis in humans.     

Effects of oxymetazoline on the ventilation of paranasal sinuses in healthy subjects

BACKGROUND: Impairment of sinus ostial function is considered an important factor in the pathophysiology of sinus disease. The use of the decongestants such as alpha2-agonists is thought to improve sinus ostial function. Previous studies have shown an effect of alpha2-agonists on maxillary sinus ostial function only when administered in nasal bellows, but not as a nasal spray or nasal drops. The effect of decongestants on ventilation of the frontal and posterior ethmoidal and sphenoidal sinuses has not been studied to date. METHODS: In this study, the 133-xenon washout method was used to determine ventilation for all paranasal sinuses before and after administration of oxymetazoline as nasal drops in eight subjects and from nasal bellows in nine healthy subjects. RESULTS: No significant effect of oxymetazoline on sinus ventilation was seen in either group. CONCLUSIONS: The results indicate that alpha2-agonists do not have any effect on sinus ventilation in healthy subjects. However, one cannot exclude that decongestants improve sinus ventilation in patients suffering from sinus disease and this requires further studies.     

Experimental studies on the relationship between maxillary sinus ventilation and various obstructions of the nose and nasopharynx

The relationship of the nasal and the antral ventilation was studied with a plastinated model of a human nose. The effects of adenoidal hyperplasia and septal deviations on the antral ventilation were measured. It could be demonstrated that the aerodynamic effect of an obstruction within the nasal cavity largely depends on the localisation of the stenosis (anterior or posterior to the maxillary ostium). Additionally, the influence of an ostial obstruction on the antral ventilation was examined in dependence on the nasal ventilation. We were able to demonstrate that the antral pressure variations not only reflect the ostial function but as well the total aerodynamics of the upper respiratory tract. From this point of view we discuss diagnostic and therapeutic conclusions.     

Pre- and postoperative sinus penetration of nasal irrigation

Objective/Hypothesis: Endoscopic sinus surgery is an accepted treatment for medically recalcitrant chronic rhinosinusitis. Effective saline douching may improve long‐term outcomes of chronic rhinosinusitis but is often impaired by postoperative ostial stenosis. The aim of this study is to determine a critical ostial size at which douching solution reliably enters the sinus cavities. Study Design: Prospective study of consecutive patient cohort. Methods: Seventeen preoperative or well‐healed postoperative endoscopic sinus surgery patients were irrigated with 5 mL blue food coloring mixed with 200 mL buffered saline from a squeeze bottle. The degree of sinus penetration, sinus ostial patency, and ostial size were endoscopically determined. Results: Sinuses penetrated by blue dye had a significantly larger minimal ostial dimension (7.31 mm; 95% confidence interval 5.54–9.08) than those that had no blue dye penetration (1.26 mm; 95% confidence interval 0.86–1.66) as determined by Student t test. Chi‐square analysis showed that operated sinuses were more likely to be penetrated than nonoperated sinuses (P = .0016) and obstructed sinuses (P = .0325). Logistic regression showed a 95% probability of penetration when the minimum ostial dimension is 3.95 mm or greater. Conclusions: Unoperated sinuses or cases with gross sinus ostial obstruction will not be reliably penetrated by sinus irrigant. A 3.95‐mm ostial diameter seems to be the minimum size to guarantee penetration in paranasal sinuses to maximize the potential for topical sinus treatment.     

Paranasal sinus development and choanal atresia

BACKGROUND: Although the determinates of paranasal sinus development and sinusitis are not well defined, a candidate factor is blockage of the choana. HYPOTHESIS: Maxillary sinuses ipsilateral to unilateral choanal atresia are comparatively small and have more evidence of sinusitis than do the contralateral sinuses. DESIGN: Retrospective. SETTING: Children's hospitals. PATIENTS: Sixteen nonsyndomic children with isolated unilateral congenital choanal atresia. MAIN OUTCOME MEASURES: Determination of maxillary sinus volumes and mucoperiosteal thickening on preoperative computed tomograms. RESULTS: Maxillary sinuses ipsilateral to unilateral choanal atresia have slightly larger volumes than, and mucoperiosteal thickening that is similar to, the contralateral sinuses. CONCLUSION: These data suggest that maxillary sinus development and sinusitis are independent of posterior nasal ventilation and drainage.     

大鼠慢性鼻-鼻窦炎模型的建立及其生物学特性观察

目的建立大鼠慢性鼻-鼻窦炎模型的成熟方法,观察模型建立过程中各阶段炎症发生、发展的规律和特点。方法 SD大鼠60只随机分成实验组（A、B、C、D组）和对照组（E）,实验组分别将膨胀海绵片置入大鼠左侧鼻腔,距离前鼻孔约15 mm,位于窦口鼻道复合体处,金黄色葡萄球菌标准菌株悬浊液左侧鼻腔内灌注。于术前及术后3 d、4周、8周、12周行内眦静脉/腹主动脉取血查血常规。实验组分别于术后3 d、4周、8周、12周处死,解剖并取双侧上颌窦黏膜行病理切片及双侧鼻腔分泌物培养。对照组直接处死,取双侧上颌窦黏膜行病理切片及双侧鼻腔分泌物培养。结果大鼠慢性鼻-鼻窦炎造模过程中,实验组术后3 d、4周、8周血常规白细胞计数值均显著高于术前和对照组（P〈0.01）,并在4周之内保持高水平。术后1 2周时血常规白细胞计数值较术前和对照组无明显差异（P〉0.0 5）。实验组大鼠9 5.7%（44/46）发生鼻中隔穿孔,多位于鼻中隔前下部,术后3 d内即可发生。解剖发现3 d以上各实验组双侧鼻窦均有大量脓性分泌物,术后8～12周各鼻窦脓性分泌物明显减少。病理切片显示,术后第4～12周,实验组左侧上颌窦黏膜炎症由亚急性向慢性迁延。C、D组右侧上颌窦黏膜8、12周同左侧上颌窦黏膜有相似程度的炎症。分泌物培养显示,术后第4周36.4%双侧鼻腔均培养出金黄色葡萄球菌,其他培养结果均为条件致病菌。术后12周所有培养均未检出金黄色葡萄球菌。66.7%的双侧鼻腔培养为条件致病菌,其余未检出细菌。结论鼻腔膨胀海绵填塞可有效建立大鼠慢性鼻-鼻窦炎模型,术后约4周的急性期,逐渐转向慢性炎症,至12周形成稳定的慢性炎症。此时是进行进一步干预研究的成熟时机。细菌感染与慢性鼻-鼻窦炎的炎症持续状态并无明确相关性。     

Effects of phenylpropanolamine on ostial and nasal patency in patients treated for chronic maxillary sinusitis

Ostial and nasal patency were measured in different body positions and after phenylpropanolamine (Ppa) treatment in 12 patients earlier treated for chronic unilateral maxillary sinusitis of varying severity. Six of the sinuses were of normal appearance on sinoscopy. Phenylpropanolamine in a single dose of 100 mg was found to increase the equivalent ostial diameter significantly in the sitting and recumbent positions. The drug also reduced the nasal airway resistance. The Ppa effect might be of benefit in patients treated for chronic maxillary sinusitis.     

Pneumosinus dilatans of the maxillary sinus: a case report and review of the literature

Pneumosinus dilatans (PSD) is an abnormal dilatation of one or more of the paranasal sinuses and must be included in the differential diagnosis of expansile lesions of the sinonasal tract. The frontal and sphenoid sinuses are the most frequently involved sites. Herein, we present the case of a 30-year-old woman with a 6-year history of right nasal obstruction and pain in the right maxillary region, elicited by rapid changes in atmospheric pressure. Computed tomography (CT) detailed an abnormal expansion of the right maxillary sinus resulting from a process of hyperpneumatization with no evidence of bone erosion, leading to the diagnosis of PSD. Restoration of permanent pressure equilibrium in the right maxillary sinus and improvement in the patency of the nasal fossa were achieved by a subtotal resection of the medial wall of the maxillary sinus by an endoscopic approach. Two years later, the patient was asymptomatic, and a CT scan showed no progression of the disease.     

A human study model for nitric oxide research in sinonasal disease

Sinus nitric oxide (NO) measurements present a novel and promising approach to help overcome difficulties and confounding variables associated with nasal NO measurements such as the nasal cycle, ostial patency, and individual contribution to total NO production of each sinus. Conflicting results reported on nasal NO measurements in various sinonasal diseases are presumed to originate from the variable diffusion of sinus NO into the nose where it is measured. This study presents a novel technique and research method for direct measurement of sinus NO. The authors' original technique of individual, non-destructive catheterization of the sinuses through their natural ostia is developed and refined to allow accurate measurements of NO produced in the sinuses. Our study indicates that reproducible catheterization of the sinuses through their natural ostia can be performed in the clinical research setting under local and topical anesthesia. The model can be used to test the effects of various conditions on nasal and sinus NO production in a variety of disease models and the variables affecting sinonasal gas exchange can be differentially studied. Volunteer healthy adult human subjects without nasal allergies are used. An endoscopic nasal exam with topical anesthesia followed by in vitro allergy testing is performed to determine eligibility. Sinus computerized tomography (CT) scans are used to delineate anatomic features and to calculate paranasal sinus volumes. Continuous flow sinus air sampling and NO measurement with a chemiluminescence analyzer is obtained through polyethylene tube catheters (PEC) placed endoscopically into an aerated major paranasal sinus. Catheters are introduced through natural ostia under local and topical anesthesia. Nasal and differential sinus NO measurements are performed.     

Experimentally induced rhinosinusitis in rabbits

OBJECTIVE: The purpose of this study was to develop an experimental rhinosinusitis model by using bacteria-added absorbable material for temporary ostial obstruction. METHOD: Absorbable gelatin sponge was inserted between the endoturbinals and the ostium of the sinus. In the first group, the effects of surgical procedure and Gelfoam on ostial mucosa were examined macroscopically. In the second group Gelfoam was moistened with Staphylococcus aureus (ATCC 25923). The sinuses of rabbits were examined by coronal com puted tomography before each surgical procedure and sacrifice. The animals were sacrificed at the first, second, fourth eighth, and tenth weeks. Histologic and microbiologic examinations were performed. RESULTS: In the first group, fibrotic bands and adhesions were observed between the ostium of the maxillary sinus and the endoturbinals in the first and second week. In the second group, a thick purulent discharge that invariably filled the sinuses of the inoculated side was seen after the first week of induction, and opacity, which was determined radiologically, did not disappear until the end of the study. CONCLUSION: In this study, an experimental rhinosinusitis model was accomplished. It is currently believed that obstruction of the ostium with mucosal edema, polyps, or tumour leads to maxillary sinusitis. In this model, the pathogenesis of human sinusitis was imitated by temporary occlusion of the ostium with bacteria-added Gelfoam. This model can be used in further studies to explore the role of the ostium in the pathogenesis of sinusitis.     

鼻窦球囊导管扩张术联合纤维鼻咽喉镜治疗鼻窦囊肿

目的 评价鼻内镜鼻窦手术和鼻窦球囊导管扩张术联合纤维鼻咽喉镜治疗鼻窦囊肿的疗效。方法 分析14例(19个上颌窦,3个额窦)应用鼻窦球囊导管扩张术联合纤维鼻咽喉镜手术切除鼻窦囊肿(球囊组)和16例(23个上颌窦,8个额窦)采用常规鼻内镜鼻窦手术方式切除鼻窦囊肿(常规组)病例的临床资料。依视觉模拟量表(visual analogue scale, VAS)记录手术难度评分和手术时间。手术前后均行鼻内镜检查、冠状位鼻窦CT检查,采用Lund-Kennedy内镜和Lund-Mackay鼻窦CT评分系统评价预后。结果 球囊组手术难度高于常规组,手术时间也较长,两组间差异有统计学意义（P<0.001）。术后观察8、24周, 鼻内镜检查见窦口通畅,Lund-Kennedy内镜和Lund-Mackay鼻窦CT评分结果显示,所有病例术腔恢复良好,术后鼻窦CT影像示改善明显,但两组比较差异无统计学意义（P>0.05）。结论 球囊组与常规组行鼻窦囊肿手术可获得同-良好的疗效。球囊组的手术方式能够保留鼻腔鼻窦的正常结构,手术微创。由于纤维鼻咽喉镜手术器械的限制,手术难度较常规组高,手术时间较长。     

The influence of the size of the maxillary sinus ostium on the nasal and sinus nitric oxide levels

BACKGROUND: Nitric oxide (NO) is produced in significant quantities in the nasal sinuses and is thought to have a beneficial effect on the mucociliary transport of the sinuses and nose and to have significant antibacterial properties that contribute to the health of the sinuses. Recently, the concept of "mini-functional endoscopic sinus surgery" has been introduced where the uncinate is removed without enlargement of the maxillary ostium. Although no scientific evidence has been published, enlargement of the ostium is thought to possibly disrupt the mucociliary pathway and decrease the concentration of NO in the nose and sinuses. The aim of this study was to establish the effect of enlargement of the maxillary ostium on sinus and nasal NO. METHODS: Twenty-nine patients who were post-endoscopic sinus surgery were included with 52 who were maxillary sinus ostia cannulated. There were 22 large maxillary sinus ostia and 30 small ostia. Smoking, allergy status, and topical steroid use were recorded. NO levels were measured in the nose and maxillary sinus after decongestion with patients mouth breathing and breath holding. RESULTS: This study shows that enlargement of the maxillary sinus ostium above its normal size (20 mm2) produces a significant decrease in both the maxillary sinus and the nasal cavity NO levels. In addition, the size of the ostium showed a significant correlation to the sinus NO level. Use of topical nasal steroid sprays and topical decongestants were shown to effect NO levels in the sinuses and nasal cavity. The lowered levels of NO were found irrespective of the technique of measurement of the NO. CONCLUSIONS: The effect of this lowered NO level on the susceptibility of the maxillary sinuses to recurrent infection is yet to be determined.     

流体力学方法测量全鼻窦开放对鼻腔鼻窦气流的影响

目的 从流体力学角度探讨全鼻窦开放术对鼻腔鼻窦气流的影响,比较鼻腔鼻窦气流走向、速度、压力和分布以及鼻腔鼻窦气流交换在手术前后的差异.方法 在1例健康成年女性鼻窦CT扫描基础上,使用Fluent 6.1.22软件模拟出正常人鼻腔鼻窦结构,并在此基础上再模拟出鼻内镜下全鼻窦开放手术后的鼻腔鼻窦模型,利用Navier-Stokes方程计算、比较手术前后气流流速、压力、分布和迹线.结果 ①全鼻窦开放术后鼻腔总鼻道气流量明显减少,中鼻道和开放的筛窦连通区域的气流量增加,在稳态吸气时增加10%,呼气时增加9%;②全鼻窦开放术后相当于原窦口鼻道复合体的手术区域的气流速度提高,鼻腔流场的最大速度发生了变化,手术后吸气时左侧鼻腔出现了2个高速区域,一是与手术前一致的下鼻甲前端的高速区域,另一区域在中鼻道的前端,相当于原钩突与中鼻道之间的区域,速度为5.03 m/s;③全鼻窦开放术后气流在鼻前庭、总鼻道、下鼻道、鼻咽等位置的迹线与手术前大致相近,但手术区域的气流轨迹发生了较大变化,上颌窦、筛窦连通区域和蝶窦内形成大范围的涡旋;④全鼻窦开放术后鼻腔的总体压强逐渐降低,鼻腔中部压强降低较为明显;⑤全鼻窦开放术后各鼻窦内气流均有不同程度增加,上颌窦最多,蝶窦次之,额窦气流增加不明显.结论 全鼻寞开放术后鼻腔以中鼻道为主的手术区域的气流速度、流量和迹线都有可能发生变化;各鼻窦的气流增加,上颌窦最为明显.     

Ostial and nasal patency in chronic maxillary sinusitis. A long-term post-treatment study

In a long-term follow-up study (mean 3.5 years) after treatment of chronic maxillary sinusitis of either rhinogenous or dental origin, 72 sinuses in 66 patients were examined with respect to maxillo-ostial and nasal resistance. In sinusitis of rhinogenous etiology, the mean equivalent ostial diameter was pathologically narrowed (0.89 mm, in patients treated conservatively) whereas it was normal (2.51 mm) in sinusitis of dental etiology (dental treatment in combination with local sinus surgery). In the former group, all sinuses were diseased, compared with 3 out of 23 in the dental group. In order to distinguish between functional and organic ostial stenosis, the patients were also tested after physical exercise. The functional ostial diameter in healthy sinuses was significantly increased in contrast to the diseased sinuses. In one patient the narrow ostium was due to mucosal swelling only, but in the other cases was caused mainly by an organic stenosis. In sinusitis of rhinogenous etiology, a pathologically increased nasal resistance was found in 14.3%, while the corresponding figure in the dental group was 4.3%. Improved sinusal and nasal ventilation, achieved either pharmacologically or, preferably by surgical intervention, seems necessary for successful treatment of chronic maxillary sinusitis.     

Evaluation and treatment of antrochoanal polyps

OBJECTIVES: Antrochoanal polyp (ACP) is a benign maxillary sinus polyp that originates from the mucosa of the maxillary sinus, passes through a sinus ostium, and extends into the choana. The common presentation of ACP is unilateral nasal obstruction. The radiographic findings and differential diagnosis of ACPs are discussed by comparing them with data in the literature. METHOD: This study included 19 (14 male, 5 female; median age 24.5 years, range 8-75 years) surgically treated patients with ACPs diagnosed by clinical examination, nasal endoscopy, and computed tomography. RESULTS: Nasal obstruction was found in all cases. Endoscopic sinus surgery was preferred for removal of the nasal part of ACPs in 13 cases. Only in one case, polypectomy combined with Caldwell-Luc operation and septoplasty was performed. The observed complications were as follows: minor hemorrhage in three cases, mild cheek swelling with pain in two patients, and infraorbital hypoesthesia in one case. Histopathologic examination of ACPs revealed loose mucoid stroma and mucous glands, which were covered by respiratory epithelium. CONCLUSION: Endoscopic sinus surgery may be indicated in patients with ACPs because the function and capacity of the maxillary antrum are preserved. The greater portion of the antral part of polyp can be removed while leaving the healthy antral mucosa intact.     

A study of microdensitometric evaluation of opacity of maxillary sinuses in patients with nasal allergy

The opacity of the maxillary sinuses on X-ray film in Waters' view in patients with nasal allergy was evaluated by a microdensitometer. The patients with nasal allergy were diagnosed with the positive results of the following; 1) eosinophilia in nasal secretion, 2) nasal provocation test, 3) intradermal skin test or radioallergosorbent test (RAST). The ratio of density of the maxillary sinuses and orbits was determined by a microdensitometer, and the ratio of the average degree of the opacity of the maxillary sinus to that of the ipsilateral orbit was designated as the M/O ratio. The normal range of the M/O ratio was set over the mean value -2 standard deviations in the normal group. The results are followings. 1) The abnormal shadows in the maxillary sinuses were found out to be 36.9% in patients with nasal allergy. 2) Patients under 15 years old had significantly higher incidence of abnormal shadows, especially in the bilateral sinuses compared with patients over 15 years old. 3) Polyps in the maxillary sinus were recognized in 5.0% of all the sinuses. 4) There were no significant differences for the incidence of abnormal shadow among the patients with nasal allergy caused by different antigens.     

Nasal airflow, mucociliary clearance, and sinus functioning during viral colds: effects of allergic rhinitis and susceptibility to recurrent sinusitis

BACKGROUND: The aim was to compare nasal airflow and mucociliary clearance (MCC) and their association with paranasal sinus functioning during acute natural colds and convalescence in allergic and sinusitis-susceptible patients and healthy controls. METHODS: Nine allergic subjects, 16 sinusitis-susceptible subjects, and 20 healthy controls were examined during days 2-4 of acute colds and 3 weeks later by taking viral specimens, recording symptoms, performing rhinomanometry and dyed saccharin tests, and evaluating sinus functioning with computed tomography (CT). RESULTS: Viral etiology of the cold was identified in 31 (69%) subjects. Nasal airflow was decreased and MCC time prolonged during the cold compared to convalescence. A higher proportion of the allergic subjects, but not of the sinusitis-susceptible subjects, compared to the control subjects tended to have abnormal nasal airflow and MCC values. Abnormal nasal airflow and MCC values associated significantly with higher ipsilateral paranasal sinus CT scores. CONCLUSION: Abnormal nasal airflow and MCC rates seem to be associated with impaired functioning of paranasal sinuses during viral colds and tend to be more common in allergic subjects.