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Endoscopic Management of a Chronic Ethmoid and Sphenoid Sinus Foreign Body

ities in ciliary structure that impair mucociliary transport.9 The finding of compound cilia alone in a patient does not in itself signify diminished mucociliary clearance. This finding requires evaluation with other tests such as technetium-99labeled albumin scanning or possibly the cost-effective saccharin test.1 Ciliary motion also can be evaluated with highspeed cinematography or a video system with slowor stopmotion capabilities when viewing through a phase-contrast microscope.2 The effects of compound cilia and other nonspecific axonemal defects on mucociliary clearance are not completely understood.3 Our patient had slightly diminished mucociliary clearance, which can be attributed to her high numbers of compound cilia. These cilia are known to exist in mucosal disorders such as chronic rhinitis, sinusitis, and PCD, but it is unclear whether the abnormality is a cause or result of the disease. Conceivably the compound cilia are a result of mucosa undergoing rapid regeneration from various infectious conditions and conditions leading to ciliary destruction. Regardless, this abnormality may be seen in patients with chronic respiratory illnesses and, as in our case, in those with a mild immunodeficiency. More knowledge is needed concerning the influence of these ultrastructural abnormalities on the effectiveness of the mucociliary transport mechanism. REFERENCES