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Mucociliary clearance before and after endonasal sinus surgery for chronic rhinosinusitis with and without nasal polyps
Boris R. Haxel1,2, Niki Karaiskaki2, Patrick Boessert1,2, Kai Fruth2
1MD, Department of Otolaryngology, Head and Neck Surgery, AMEOS Klinikum Haldensleben, Germany.
2MD, Department of Otolaryngology, Head and Neck Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Germany.

Article ID: 100008O04BH2017
doi:10.5348/O04-2017-8-OA-1

Address correspondence to:
Boris R. Haxel
Department of Otorhinolaryngology, Head and Neck Surgery
AMEOS Klinikum Haldensleben
Kiefholzstr 27, D-39340 Haldensleben
Germany

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How to cite this article
Haxel BR, Karaiskaki N, Boessert P, Fruth K. Mucociliary clearance before and after endonasal sinus surgery for chronic rhinosinusitis with and without nasal polyps. Edorium J Otolaryngol 2017;3:1–7.


Abstract
Aims: Mucociliary function is an important protective mechanism of the nasal mucosa that comprises cilia motility and the consistency of the nasal mucus. This study intended to investigate this feature and how it changes following functional sinus surgery (FESS) for chronic rhinosinusitis (CRS) with (CRSwNP) and without (CRSsNP) nasal polyps, in comparison to other parameters associated with this disease.
Methods: In 37 patients with CRS±polyps, the saccharin transit time (STT) was measured prior to FESS, as well as two weeks after and six months after. Other parameters like SNOT-20 scores, olfaction, CT and endoscopy scores were also evaluated.
Results: There was an insignificant preoperative difference in STT between the CRS subgroups with or without polyps (23.1 and 15.6 minutes respectively). There was also no statistical difference in terms of gender, preoperative CT score or previous surgery, nor was there any correlation with other parameters (like SNOT-20, olfaction and endoscopy score). Two weeks following FESS, a strong trend towards increased STT values (26.4±17.7 minutes, p = 0.051) and a decrease six months later (19.8±14.2 minutes, p = 0.16) were observed. Although other parameters like SNOT-20 scores, olfaction and endoscopy scores showed significant improvement, no correlation with the changes in STT was noticed.
Conclusion: In CRS with or without nasal polyps, STT seems to be an inappropriate parameter for estimating the efficacy of FESS. The changes in STT do not correlate with other indicators for successful surgery like increased SNOT-20 or olfaction scores. STT was independent of other factors like gender, CT-score, previous surgery and polyp status. However, CRSwNP patients showed higher STT values.

Keywords: CRS, FESS, polyps, Saccharin Transit Time


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Author Contributions:
Boris R. Haxel – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Niki Karaiskaki – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Patrick Boessert – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Kai Fruth – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Boris R. Haxel et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



About The Authors

Boris R. Haxel is Head of Department of Otorhinolaryngology, Head & Neck Surgery at AMEOS Hospital Haldensleben in Germany. He obtained his medical and scientific education (M.D. and PhD) at the Johannes-Gutenberg University of Mainz, Germany and received an additional qualification in Allergology and Plastic Surgery. He received a Scholarship of the German Research Society (DFG) as a research fellow at the Center of Molecular Neurobiology, School of Biomolecular and Biomedical Science, Griffith University, Brisbane, Australia and he has published more than 30 research papers in national and international academic journals and authored two book chapters. His research interests include rhinology, allergology, smell and taste disturbances and head and neck cancer.



Niki Karaiskaki is Consultant of Otorhinolaryngology, Head & Neck Surgery at Helios Dr. Horst Schmidt Hospital Wiesbaden, Germany. She received her medical degree from University of Patras, Greece. She then completed her training in Otorhinolaryngology, at the Otorhinolaryngology, Head & Neck Surgery Clinic of the University Hospital of Mainz and obtained a PhD from the Medical School of the same University. She was further trained and certified in Allergology and Sleep Medicine. She has published 5 research papers in national and international academic journals. Her research interests include rhinology, allergology and sleep medicine.



Patrick Boessert is a Consultant at the Department of Otorhinolaryngology, Head & Neck Surgery at AMEOS Hospital Haldensleben in Germany. He obtained his ENT speciality training at Johannes-Gutenberg University of Mainz, Germany and received an additional qualification in Allergology. He received a Scholarship of the German Research Society (DFG) as resident at Westmead Hospital, Sydney, Australia. His research interests include rhinology, smell and taste disturbances and head and neck cancer.



Kai Fruth is a Senior Consultant of the Department of Otorhinolaryngology, Head & Neck Surgery at Dr. Horst Schmidt Kliniken Wiesbaden. He was trained at the Johannes-Gutenberg University of Mainz, Germany specialized in rhinology and facial plastic surgery. He performed basic research and clinical studies with emphasis on chronic rhinosinusitis and Aspirin exacerbated respiratory disease and published the results in international journals. His research interests include rhinology, chronic rhinosinusitis and oncology.