Analysis of the relationship between nasal mucosa mucociliary clearance parameters and the duration and severity of nasal obstruction

Abstract

In press

Background. One of the common causes of cilia loss in the nasal mucosa is impaired aerodynamics within the nasal cavity. However, the mechanisms underlying the pathogenesis of functional changes in mucociliary clearance associated with impaired nasal aerodynamics remain controversial and poorly understood.

Aim. To identify and analyze the relationship between mucociliary clearance parameters of the nasal mucosa and the duration and degree of nasal obstruction, in order to assess the nature and severity of functional impairments in mucociliary transport.

Materials and Methods. A total of 196 patients with varying degrees of nasal obstruction accompanied by impaired respiratory and olfactory function, with disease duration ranging from 1 month to 5 years, were examined and divided into four groups. Clinical evaluation included assessment of complaints, medical history, otorhinolaryngological examination, rhinomanometry, olfactometry using the Sniffin’ Sticks test (Burghardt®, Germany), including threshold and identification subtests, and assessment of mucociliary clearance. Statistical data analysis was performed using Excel 2022 (Microsoft, USA). The study was conducted within the framework of research projects with state registration numbers 0122U200258 and 0125U001264.

Research Ethics. The study was conducted in accordance with the ethical standards of the Declaration of Helsinki of the World Medical Association (1964–2024), the European Society Directive 86/609 on the participation of humans in biomedical research, and the Order of the Ministry of Health of Ukraine No.690 of September 23, 2009. All study participants provided informed consent.

Results. The most pronounced impairments of ciliary function were observed in patients of Group 3 (ciliary beat frequency (CBF) [6.8±2.2] Hz, saccharin test [34.7±3.3] min) and Group 1 (CBF [7.3±1.4] Hz, saccharin test [24.5±3.1] min), both of whom had severe nasal obstruction. In addition, patients in both groups exhibited marked olfactory dysfunction, reflected by an increased odour detection threshold ([4.1±1.3] points and [3.4±2.4] points, respectively). In patients of Groups 2 and 4, who had moderate and mild nasal obstruction, respectively, partial ciliary dysfunction was observed (CBF [7.6±3.1] Hz, saccharin test [18.0±2.4] min; and CBF [8.2±1.3] Hz, saccharin test [15.0±2.4] min, respectively). However, patients in Group 4 demonstrated marked olfactory dysfunction based on threshold and identification tests, in contrast to Group 2 patients, who showed a mild degree of dysosmia.

Conclusions. It has been determined that a pronounced correlation exists between nasal breathing indicators and the motility of ciliated cells, which directly impacts the functioning of mucociliary clearance.

Keywords: otorhinolaryngology, ciliated epithelium, respiratory disorders, olfactory dysfunction, COVID-19, rhinomanometry.