Immotile cilia syndrome in children.

Nasal mucociliary function was studied in 46 children suffering from recurrent respiratory infections, sinusitis and otitis media. Mucociliary transport velocity was measured by a radioisotopic method using 99mTc-labelled human serum albumin as a tracer substance. In 31 patients mucociliary transport was markedly impaired, 0-5 mm/min (average 1.9 mm/min), whereas in healthy children it was 6-9 mm/min. Transmission electron microscopic studies of the cilia discovered many structural variations. Two patients, who did not have dextrocardia and who had had respiratory difficulties from birth onwards, had the immotile cilia syndrome, with total absence of dynein arms in the ciliary cross-sections. In the study of recurrent and chronic bronchitis, sinusitis and otitis media in children the radioisotopic method is recommended for initial examination and, if a lowered mucociliary activity is detected on both sides of the nose, a sample of nasal or bronchial mucosa should be taken for electron microscopic studies.