Sinonasal mucociliary clearance in health and disease.

摘要: Although much has been elucidated in the past 170 years concerning precise mechanism of ciliary function healthy or diseased human respiratory system, significant questions remain. The first description action is credited to Sharpey 1835. However, importance mucosal was not apparent until Hilding's investigations postsurgical canine sinus demonstrated scar formation and disruption mucociliary clearance. Subsequently, several techniques for coverage exposed bone, most notably by Sewall Boyden, were reported. underlying physiology explaining mucosa concept preservation became with sinonasal flow patterns Messerklinger; thus restoration natural physiology, ie, clearance, goal both medical surgical treatment inflammatory disease. Clearance benign pathological substances mucus governed propulsive force beating cilia physical characteristics overlying mucus. continually beat a coordinated fashion, times stress (eg, exercise, infection, fever) frequency increases accelerate Thus, upper airway motility under dynamic modulation. Multiple incontrovertibly demonstrate marked decrease clearance patients chronic rhinosinusitis. Possible explanations this finding are 1) reduced basal frequency, 2) an alteration viscoelastic properties secretions, and/or 3) blunted response environmental stimuli. Studies two yield conflicting results, date, third possibility remains uninvestigated. A review current understanding cellular regulation activity its contribution rhinosinusitis presented.