Hüttenbrink K-B, Wrede H, Lagemann S, Schleicher E, Hummel T
Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Köln.
Laryngorhinootologie. 2006 Jan;85(1):24-31. doi: 10.1055/s-2005-870354.
Mucociliary clearance is one of the major functions of the nasal epithelium. Limited information on the physiology or malfunction could up to now only be obtained by experimental investigations in vitro with cytological measurements of ciliary beat frequency or with extensive, time-consuming in-vivo-tests.
We developed a new technique, which measures the transport capacity at various locations at the mucosa in the nose of a sitting patient with a short (30 sec) video-endoscopic examination. The velocity of a 500 microm TiO2-microsphere as inert marker, which is placed on the mucosa region of interest, is measured by a vector-analytic calculation in mm/min.
: We validated this technique in 20 subjects with measurements on the floor of the nose. The inter-individual variance and variable transport speed at different locations as known from the literature could be confirmed.
This technique allows for the first time to measure the mucociliary clearance at various locations inside the nose of a patient in a short and easy to perform procedure, which up to now necessitated extensive or experimental set-ups. Besides the establishment of a register of mucociliary clearance at various anatomical localisations inside the nose (olfactory epithelium, conchae, surrounding of the ostiae etc.), we intend to verify if this technique can be used as a new diagnostic tool to obtain a deeper insight into some pathologic alterations or uncharacteristic symptoms ("post-nasal-drip") or drug-effects in the nose and in the tracheo-bronchial system.
黏液纤毛清除是鼻上皮的主要功能之一。到目前为止,关于其生理学或功能障碍的信息有限,只能通过体外实验研究,对纤毛摆动频率进行细胞学测量,或通过耗时的体内广泛测试来获取。
我们开发了一种新技术,通过简短(30秒)的视频内镜检查,测量坐位患者鼻腔黏膜不同部位的转运能力。将500微米的二氧化钛微球作为惰性标记物放置在感兴趣的黏膜区域,通过矢量分析计算以毫米/分钟为单位测量其速度。
我们在20名受试者的鼻底进行测量,验证了该技术。文献中已知的个体间差异以及不同部位的可变转运速度得到了证实。
这项技术首次能够在一个简短且易于操作的过程中,测量患者鼻腔内不同部位的黏液纤毛清除情况,而此前这需要广泛的或实验性的设置。除了建立鼻腔内不同解剖部位(嗅上皮、鼻甲、窦口周围等)的黏液纤毛清除登记册外,我们还打算验证该技术是否可作为一种新的诊断工具,以更深入了解一些病理改变或非特异性症状(“鼻后滴漏”),或鼻腔及气管支气管系统中的药物作用。