Dear Andrey, dear Yehudah,

The assessment of mucociliary clearance of maxillary sinuses would be an 
excellent tool for routine clinical use, but until now we do not have method 
that would be suitable for it. The biggest problem of our method is the 
relatively high cost of  using isotope and gamma camera.  The dose of radiation 
from isotope is also very small (about 10% of sinus x-ray) and should not be any 
problem.

I do not find antral puncture so traumatic that we could not use it as a 
preoperative examination for patients who are suffering from chronic sinusitis. 
In Finland antral puncture is still used a lot as a treatment of acute maxillary 
sinusitis. It is teached for all medical students and about 50 % of general 
practitioners are using antral puncture in their practise. 

We have also tried endoscopically guided administration of tracer into the 
sinuses and I agree that with endoscopes we have nowadays it is really difficult 
and causes too much suffering for patients.  

Best regards

Markus


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