Radioisotopic Method for Measurement of Nasal Mucociliary Activity

Abstract

\s=b\A single droplet of technetium Tc 99m\p=n-\markedhuman serum albumin is placed on the floor of the nasal meatus about 1 cm behind the mucocutaneous junction and its course is followed with a gamma camera. The velocity of mucociliary transport was, on average, 9.0 mm/ min, with a range of 5.8 to 13.5 mm/min, in adults. When the measurement was performed on four healthy children aged 2, 5, 6, and 15 years, the velocity of mucociliary transport was 6.0 to 9.6 mm/ min. The method is safe, easy, quick, and places no strain on the patient. It is, therefore, very suitable for clinical work, eg, for study of impaired mucociliary function in patients with respiratory diseases, including immotile cilia syndrome. (Arch Otolaryngol 1982;108:99-101) Primary or secondary disturbance of mucociliary activity is quite clearly a much more common cause of long-term respiratory diseases, nasal infections, sinusitis, and otitis media than presently recognized. In recent years, the so-called immotile cilia syn¬ drome has been a focus of interest.1 This syndrome includes, for example, Kartagener's syndrome, which is fa¬ miliar to clinicians. In this syndrome, inadequate mucociliary function is caused by structural abnormalities in the cilia. The most typical changes, observed in ciliary cross sections, are the absence of dynein arms2,3 contain¬ ing adenosine triphosphatase, but other anomalies have also been observed.4,5Examination of the cilia requires transmission electron microscopy, which is a too time-consuming method for routine clinical use. It would be desirable to be able to exam¬ ine mucociliary function by a simple test. Consequently, we have adapted for routine use a rapid and convenient isotopie method. METHODThe tracer used is a human serum albu¬ min labeled with technetium Tc 99m. One drop (0.01 mL) is placed under visual con¬ trol on the floor of the nasal meatus, at least 1 cm behind the anterior end of the inferior turbinate. This can easily be done by means of the so-called tuberculin syringe, with a thin injection needle attached. The needle is extended by a soft Teflon catheter measuring approximately 4 cm in length and 0.5 mm in diameter. The seated subject is advised to breathe nor¬ mally, via the nose or mouth, and to avoid snuffling. Transport of the tracer sub¬ stance is monitored by means of a gamma camera from either side of the head at oneto three-minute intervals, for up to ten to 15 minutes, by which time the tracer has normally reached the nasopharynx. The course of the tracer is documented photo¬ graphically. The result is recorded in milli¬ meters per minute. If the tracer does not move, the result is confirmed by imme¬ diately repeating the examination, using the opposite nasal meatus.The radioactivity of 1 drop of the tracer substance is 50 to 100 µ as measured by an isotope calibrator. The patient is exposed to a very low radiation dose. The highest radioactivity dose is obtained when the tracer does not move and the 100-µ dose of technetium Tc 99m human serum albumin activity is focused on ...

Primary Ciliary Dyskinesia and Nasal Mucociliary Clearance

“…This is in agreement with the findings of other investigators [12,13]. Karja et al [14] reported a faster clearance rate (0.90cm/min). In contrast with some findings in the literature, all healthy per sons in this study showed a normal muco ciliary transport at the first measurement.…”

Evaluation of Nasal Mucociliary Functions with Rhinoscintigraphy in Coal Workers’ Pneumoconiosis

“…Rhinoscintigraphy is a simple, sensitive and objective method that enables quantitative analysis [6-8, 11, 16] . Various radioisotope methods have been proposed for rhinoscintigraphy, but 99m Tc-MAA is preferred by most authors [6,7,17,18] . In the literature, there is no study to measure NMC in coal workers by using 99m Tc-MAA.…”

Dyskinetic cilia syndrome: clinical, radiographic and scintigraphic findings

“…Nasal ciliary clearance studies were performed in six patients using Karja's technique [16]. This involves placement of a drop (approximately 0.01 ml) of human serum albumin labeled with technetium (Tc-99m), on the floor of the nasal meatus.…”

“…If no movement is apparent, the test is repeated immediately using the opposite nasal meatus. In children, the velocity of mucociliary transport is reported to range from 6 to 9.6 mm/min [16].…”