Keywords
ciliary epithelium
nasal obstruction
olfactory dysfunction
COVID-19
rhinomanometry
How to Cite
Abstract
In press
Background. MucoCiliary Clearance (MCC) is the primary protective mechanism of the upper respiratory tract. Differentiating between extracellular (functional-mechanical) and intracellular (viral cytopathic) mechanisms of MCC impairment has been studied insufficiently but critical for selecting adequate therapeutic strategies.
Aim. To investigate the pathophysiological mechanisms of MCC in patients with respiratory and olfactory disorders depending on the duration and degree of nasal obstruction, and in patients post-Coronavirus Disease 2019.
Materials and Methods. A prospective observational study included 196 patients (mean age [37.4±13.1] years) with nasal obstruction and impaired respiratory/olfactory functions (disease duration from 1 month to 5 years). Patients were divided into four groups: Group 1 (n=53) – pronounced chronic nasal obstruction ([3–5] years); Group 2 (n=48) – partial obstruction (up to 6 months); Group 3 (n=44) – pronounced obstruction (up to 1 month); Group 4 (n=51) – acute post-viral rhinosinusitis after Severe Acute Respiratory Syndrome Coronavirus 2. Two pathogenetic profiles were evaluated: functional-mechanical (groups 1–3) and viral cytopathic (Group 4). Assessment included rhinomanometry, Saccharin Transit Time (STT), olfactometry (Sniffin’ Sticks), and high-speed video microscopy of ciliary epithelium (×100, 120 frames/s) analyzed in ImageJ/ciliaFA. Statistical processing of the data was performed using one-way analysis of variance (ANOVA) with post hoc Student’s test and Bonferroni correction and Pearson correlation with Excel 2022 (Microsoft, USA). The article is a part of scientific research with state registration number 0125U001264.
Research Ethics. The study complied with the World Medical Association Declaration of Helsinki (1964–2024) and relevant Ministry of Health of Ukraine orders. All participants provided written informed consent.
Results. In Group 1, aerodynamic resistance was [3.1±0.4] kPa·s/L, STT was [24.5±3.1] min, and ciliary beat frequency (CBF) was [7.3±1.4] Hz; metachronal wave was absent in 100% of cases, with hyposmia in 100% ([4.1±1.3] points). In Group 2, STT was [18.0±2.4] min, CBF was [7.6±3.1] Hz; in Group 3, STT was [34.7±3.3] min, CBF was [6.8±2.2] Hz. In Group 4, resistance was [1.9±0.4] kPa·s/L, STT was [17.0±1.9] min, and CBF was [8.1±1.4] Hz. Here, anosmia was present in 31.6% ([0.9±0.5] points) and hyposmia in 68.4% ([4.1±0.9] points).
Conclusions. Two fundamentally different pathophysiological profiles of MCC dysfunction were identified: functional-mechanical origin(groups 1–3) and viral cytopathic origin (Group 4), requiring diametrically opposite therapeutic strategies.
Keywords: otorhinolaryngology, ciliary epithelium, nasal obstruction, olfactory dysfunction, COVID-19, rhinomanometry.
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