Impact of Local Anesthesia on Ciliary Dyskinesia Diagnosis by Digital
High-Speed Videomicroscopy
Abstract
Summary: This prospective study investigates the impact of local
anesthesia on ciliary function in nasal epithelium. The primary
objective was to assess whether lidocaine 2% and naphazoline 0.5%
nasal spray alter ciliary beat frequency and pattern in subjects
undergoing nasal brushing, aiming to enhance primary ciliary dyskinesia
(PCD) diagnosis. Hypothesis: It was hypothesized that local anesthesia
administration would not significantly affect ciliary function in nasal
epithelium. Study design: A prospective, simple-blind randomized study
was conducted between 2020 and 2023. The study employed digital
high-speed videomicroscopy to analyze ciliary beat frequency and
pattern. Patient/subject selection: A cohort of 38 participants was
recruited, consisting of 25 healthy volunteers and 13 referred
individuals (including 7 diagnosed with PCD). Selection criteria ensured
absence of chronic respiratory diseases, recent respiratory tract
infections, or regular use of nasal medications. Methodology:
Participants underwent nasal brushing with administration of lidocaine
and naphazoline nasal spray in one nostril and saline in the
contralateral nostril. Ciliary beat frequency and pattern were measured
using digital high-speed videomicroscopy. Results: Nasal spray
administration did not significantly alter ciliary beat frequency or
pattern compared to saline (p = 0.841 and p = 0.125, respectively).
Subgroup analysis revealed consistent results across healthy volunteers,
referred patients, and PCD patients. Conclusion: Local anesthesia with
lidocaine and naphazoline spray did not affect ciliary function
outcomes. These findings support the safe use of these agents in
clinical practice for PCD diagnostic procedures. Further research with
larger cohorts is warranted for validation.