Pulmonary aspiration of nasal secretions in patients with chronic sinusitis and asthma.
BACKGROUND
The role of silent aspiration of nasal secretions in the pathogenesis of asthma has often been questioned.


OBJECTIVE
To investigate the presence of pulmonary aspiration of nasal secretions during sleep in patients with chronic sinusitis and asthma and in healthy controls.


METHODS
Prospective, controlled trial.


METHODS
The study included 13 patients with chronic sinusitis and asthma and 12 healthy controls. The diagnoses were based on history, physical examination findings, radiologic assessments, and pulmonary function test results.


METHODS
A radioactive tracer was prepared by diluting 10 mCi of technetium 99m-labeled macroaggregated albumin in 10 mL of physiologic saline. At 10 PM, just before the patients went to sleep, the solution was sprayed into their nostrils. The subjects were examined with a gamma camera to obtain views of the thorax at 8 AM the following morning. The average counts of the lungs and background and the actual lung counts (average lung count minus average background count) were determined.


RESULTS
The average counts of the lungs were significantly greater than the average counts of the background in both the sinusitis-asthma group (P =.001) and the control group (P =.002). The difference in the actual counts of the lungs was not significant between the 2 groups (P =.79).


CONCLUSIONS
The nasal secretions were aspirated into the lungs both in patients with sinusitis and asthma and in healthy adults during sleep, and the relative amounts that were aspirated did not differ significantly between the 2 groups (P =.79). The amount of the aspirated material alone is probably not responsible for the pathogenesis of asthma in patients with chronic sinusitis.
Ozcan
Muge
M
Clinic of Otorhinolaryngology, Ankara Numune Education and Research Hospital, Ankara, Turkey. mugeozcan@yahoo.com
Ortapamuk
Hulya
H
Naldoken
Seniha
S
Olcay
Isil
I
Ozcan
K Murat
KM
Tuncel
Umit
U
D001249:Asthma / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D002908:Chronic Disease; D005122:Exudates and Transudates; D015902:Gamma Cameras; D006801:Humans; D001239:Inhalation; D009297:Nasal Mucosa / Q000378:metabolism*; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012129:Respiratory Function Tests; D012852:Sinusitis / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D013667:Technetium / Q000493:pharmacokinetics
D019275:Radiopharmaceuticals; D013667:Technetium