Nasal mucociliary clearance in prolonged tracheostomy patients -A
prospective case-control study.
Abstract
Background: Prolonged tracheostomy bypasses the upper airways leading to
absence or reduction of nasal airflow. This altered nasal physiology not
only impairs olfaction but also may cause mucociliary dysfunction and
consequent nasal crusting and rhinosinusitis. Objective: To objectively
evaluate the extent of nasal mucociliary impairment in patients with
prolonged duration of tracheostomy. Design and Setting: This is a
prospective case-control study done in a tertiary care center wherein
the nasal mucocilary function was assessed by saccharin test in patients
who were tracheostomized for a period of more than 4 weeks and the
saccharin transit time (time taken to appreciate the sweet taste after
endoscopic insertion of saccharin pellet on anterior end of inferior
turbinate) was compared by the same test in age and sex matched healthy
individuals. Main outcome measures: Clinical data, indication of
tracheostomy and duration of tracheostomy were assessed for their impact
on the nasal mucociliary clearance using saccharin transit time in the
two groups which was then statistically analyzed using student t-test.
Results: Mean saccharin transit time in 30 patients with prolonged
tracheostomy was 934.97 seconds with a standard deviation of 75.95
seconds whereas in 30 controls, the meantime was 447.4 seconds with a
standard deviation of 63.22 seconds, which was statistically significant
(p<0.001) Conclusion: Prolonged duration of tracheostomy leads
to impaired nasal mucociliary clearance, which in turn could cause
chronic rhinosinusitis.