Evaluation of Mucociliary Activity in Maxillary Antra in Patients with Squamous Cell Carcinoma of Buccal Mucosa Undergoing Post Operative Radiotherapy

  • Abhimanyu Kadapathri
  • S. M. Azeem Mohiyuddin
Original Article


A prospective longitudinal observational study was conducted on 24 patients of histopathologically confirmed squamous cell carcinoma of buccal mucosa upon whom bilateral ‘middle meatal antrostomy was performed during the same sitting as the tumour resection with the main aim to assess the maxillary mucociliary clearance, pre-, during and post-irradiation; and compare the findings with the non-irradiated side in the same patient to avoid any confounding factors. All patients underwent methylene blue dye clearance and saccharine clearance tests before the commencement of radiation therapy, weekly during irradiation and again at first and sixth month of completion of irradiation. Pre-radiation there was statistically no difference (P > 0.05) in clearance times between both sides. But, there was a significant (P < 0.001) increase in saccharin and methylene blue clearance times on the irradiated side in comparison to contralateral non-irradiated side, during and post-radiation. It is concluded that external beam radiotherapy for oral cancers significantly affect ciliary activity in the adjacent maxillary antrum and has no effect on the opposite side. Recovery in mucociliary activity was not seen even after 6 months after radiation therapy.


Maxillary mucociliary clearance Radiation induced sinusitis Methylene blue transit time Saccharin perception test Head and neck cancer 


  1. 1.
    Ramesh C (2005) Hospital based cancer registry. Kidwai Memorial Institute of Oncology, BangaloreGoogle Scholar
  2. 2.
    Kalyani R, Das S, Singh MSB, Kumar H (2010) Cancer profile in Kolar: a ten years study. Indian J Cancer 47:160–165CrossRefGoogle Scholar
  3. 3.
    Gupta SC, Chandra S, Singh M (2006) Effects of irradiation on nasal mucociliary clearance in head and neck cancer patients. Indian J Otorhinolaryngol Head Neck Surg 58:46–50Google Scholar
  4. 4.
    Wang JH, Lee BJ, Lee JH, Kim IJ, Jang YJ (2008) Development of mucosal thickening after radiotherapy in contralateral sinuses of patients with nasal cavity and/or paranasal sinus carcinoma. Ann Otol Rhinol Laryngol 117(11):844–848CrossRefGoogle Scholar
  5. 5.
    Lou PJ, Chen WP, Tai CC (1998) Delayed irradiation effects on nasal epithelium in patients with nasopharyngeal carcinoma. Ann Otorhinolaryngol 108:474–480Google Scholar
  6. 6.
    Stringer SP, Stiles W, Slattery WH 3rd, Krumerman J, Parsons JT, Mendenhall WM et al (1995) Nasal mucociliary clearance after radiation therapy. Laryngoscope 105:380–382CrossRefGoogle Scholar
  7. 7.
    Alon EE, Lipschitz N, Bedrin L, Gluck I, Talmi Y, Wolf M, Yakirevitch A (2014) Delayed sino-nasal complications of radiotherapy for nasopharyngeal carcinoma. Otolaryngol Head Neck Surg 151(2):354–358CrossRefGoogle Scholar
  8. 8.
    Stammberger H (1986) Endoscopic endonasal surgery: concepts in treatment of recurring sinusitis. l. Anatomic and pathophysiological considerations. Otolaryngol Head Neck Surg 94:143–147CrossRefGoogle Scholar
  9. 9.
    Balaram P, Sridhar H, Rajkumar T, Vaccarella S, Herrero R, Nandakumar A et al (2002) Oral cancer in Southern India: the influence of smoking, drinking, paan-chewing and oral hygiene. Int J Cancer 98:440–445CrossRefGoogle Scholar
  10. 10.
    Nair MK, Varghese C, Swaminathan A (2005) Cancer: current scenario intervention strategies and projections for 2015. In: Burden of disease in India, background papers. National Commission for Macroeconomics and Health, Ministry of Health and Family Welfare, Government of India, New Delhi, pp 218–225Google Scholar
  11. 11.
    Singh MP, Kumar V, Agarwal A, Kumar R, Bhatt MLB, Misra S (2016) Clinico-epidemiological study of oral squamous cell carcinoma: a tertiary care centre study in North India. J Oral Biol Craniofac Res 6(1):31–34CrossRefGoogle Scholar
  12. 12.
    Gupta B, Ariyawardana A, Johnson NW (2013) Oral cancer in India continues in epidemic proportions: evidence base and policy initiatives. Int Dent J 63:12–25CrossRefGoogle Scholar
  13. 13.
    Yuan TZ, Guo X, Zheng L et al (2008) Occurrence and influencing factors of paranasal sinusitis in nasopharyngeal carcinoma patients after radiotherapy. Ai Zheng 27:866–869PubMedGoogle Scholar
  14. 14.
    Kılıç C, Tunçel Ü, Cömert E et al (2015) The effect of radiotherapy on mucociliary clearance in patients with laryngeal and nasopharyngeal cancer. Eur Arch Otorhinolaryngol 272:1517CrossRefGoogle Scholar
  15. 15.
    Asai K, Haruna S, Otori N, Yanagi K, Fukami M, Moriyama H (2000) Saccharine test of maxillary sinus mucociliary function after endoscopic sinus surgery. Larygoscope 110(1):117–122CrossRefGoogle Scholar
  16. 16.
    Kamel R, Al-Badawy S, Kandil T et al (2004) Nasal and paranasal sinus changes after radiotherapy for nasopharyngeal carcinoma. Acta Otolaryngol 124(4):532–535CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2018

Authors and Affiliations

  1. 1.BangaloreIndia
  2. 2.Department of ENTSDUMCTamaka, KolarIndia

Personalised recommendations