Objective Evaluations of Treatments in Chronic Sinusitis

This study was designed to evaluate the efficacy of various therapies in chronic sinusitis. The general effectiveness of a treatment on subjective symptoms and rhinoscopic observations was determined by the same protocol in cooperation with different clinics. It was 40% in adult and 18% in pediatric patients who received an antibiotics and a steroid by aerosol through the nose. Nasal mucociliary clearance was measured by the scaccharin method. In this method,50% of a saccharin granule was placed on a nasal septal mucosa just below the antero-inferior tip of a middle turbinate and measured the time between placing the saccharin and the moment when the subject tested its sweetness on swallowing. The patients who received repeated antral lavage improved their decelerated nasal mucociliary clearance. Since the patients with chronic sinusitis complain hypersecreted viscous nasal discharge, results from the rheological measurement of nasal mucus is an important parameter of a therapy. The elasticity and the viscosity of nasal mucus were determined by an oscillating sphere magnetic rheometer. The measurement of x-ray opacity of a maxillary sinus by microdensitometer is useful for quantitative evaluation of pathologic conditions of the sinus. In both the naxillary sinuses treated by aerosol through the nose and sinuses which received topical application of an antibiotics, the ratio of maxillary sinus density to the same side of orbital density (M/O ratio) in post-treatments was significantly improved compared with that in pre- treatments