Evaluation of Nasal Mucociliary Clearance Using Saccharin Test Versus Charcoal Test Among Filipinos in a Tertiary Government Hospital

Abstract

Background: Nasal mucociliary clearance is mainly measured using the saccharin test because it is inexpensive, readily available, and non-toxic. However, in the local setting, the authors had difficulty procuring saccharin, and this prompted the authors to look for an alternative. Upon an expansive review of the literature, the authors came to know about the use of charcoal that has the same properties as saccharin plus it is inert and easily traceable. The objectives of this study were to (1) establish the normal nasal mucociliary clearance time (MCT) using the saccharin test (ST) and charcoal test (CT) among Filipinos, (2) determine if CT can be used to determine nasal mucociliary clearance and (3) determine if the age, sex, land of dwelling, and comorbidities can prolong MCT. Methods: This is a cross-sectional study involving 50 subjects. ST and CT were performed by placing a particle of sodium saccharine and 10μg of charcoal on the medial surface and at least 1 cm behind the head of the inferior turbinate. All STs were done on the right nostril while CTs were done on the left. A 0- to 20- minute MCT was considered normal while MCT of more than 30 minutes was considered prolonged clearance. Lastly, a transit time of more than 60 minutes was considered a failed mucociliary clearance test. Results: The mean mucociliary transit time for the saccharin group was 14.48 minutes while for the charcoal group was 14.78 minutes (p=0.531). When grouped into subcategories, CT results showed a higher mucociliary clearance mean time among males, provincial residents, and those without comorbidities while ST had a higher mean mucociliary clearance time among females, Metro Manila residents, and those with comorbidities. All were noted to be not statistically significant. Conclusion: This study showed that CT is comparable with ST. Also, it can be used as an alternative to ST because the tester directly observes the charcoal transit in the oropharynx while ST relies on the patient's perception of taste that could result in false results.